Matsuda Shogo, Kirishima Toshihiko, Okamoto Naoki, Hisano Yasuko, Takai Koji, Motoyoshi Takayuki, Nishikata Makoto, Yamashita Yasuhide, Yoshinami Naomi, Shintani Hiroyuki
Department of Gastroenterology and Hepatology, Kyoto City Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2014 Oct;111(10):2013-20.
A 54-year-old woman with hematemesis was referred to our hospital. She had a history of liver cirrhosis and diabetes mellitus. After inserting a Sengstaken-Blakemore tube, we performed endoscopic variceal ligation for ruptured esophageal varices. On the third day of admission, she developed septicemia and necrotizing fasciitis caused by Bacillus cereus. She was successfully treated with early debridement of both lower extremities and intravenous treatment with vancomycin, ciprofloxacin, and clindamycin. Although B. cereus is an attenuate bacterium, it can occasionally cause fatal infection in immuno-compromised individuals, such as those with liver cirrhosis.
一名54岁呕血女性被转诊至我院。她有肝硬化和糖尿病病史。插入Sengstaken-Blakemore管后，我们对破裂的食管静脉曲张进行了内镜下套扎术。入院第三天，她发生了由蜡样芽孢杆菌引起的败血症和坏死性筋膜炎。通过早期对双下肢进行清创以及静脉注射万古霉素、环丙沙星和克林霉素，她得到了成功治疗。虽然蜡样芽孢杆菌是一种减毒细菌，但它偶尔会在免疫功能低下的个体中引起致命感染，比如肝硬化患者。
