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儿童中海洋库克菌自发性腹膜炎的首例报告。

First report of Kocuria marina spontaneous peritonitis in a child.

作者信息

Brändle Gabriel, L'Huillier Arnaud G, Wagner Noémie, Gervaix Alain, Wildhaber Barbara E, Lacroix Laurence

机构信息

Pediatric Emergency Medicine, Child and Adolescent Department, University Hospitals of Geneva, Avenue de la Roseraie 47, CH-1211, Geneva 14, Switzerland.

, Present address: 37 Bd de la Cluse, CH-1205, Geneva, Switzerland.

出版信息

BMC Infect Dis. 2014 Dec 30;14:719. doi: 10.1186/s12879-014-0719-5.

Abstract

BACKGROUND

Spontaneous bacterial peritonitis (SBP) is a rare affection in the pediatric population. It usually occurs when concurrent conditions are present, such as nephrotic syndrome, peritoneal dialysis or liver disease. We report a case of spontaneous bacterial peritonitis due to Kocuria marina in a 2-year-old child with no underlying risk factor. This is both the first description of an infection caused by this rare pathogen in a child and the first reported case of primary peritonitis caused by K. marina in a patient with no predisposing condition.

CASE PRESENTATION

A 2 year-old boy presented to the Pediatric Emergency Department with clinical signs of peritonitis. Laparoscopic surgical exploration confirmed purulent, generalized peritonitis without perforation. Culture of the peritoneal fluid revealed the presence of Kocuria marina, a Gram-positive coccoid environmental bacteria. After peritoneal lavage and appropriate antibiotic treatment, the patient improved and was discharged without sequel.

CONCLUSION

The present report illustrates the first clinical presentation of Kocuria marina SBP in a child with no underlying risk factor. Although never previously described in healthy patients, this pathogen may therefore be considered as a possible cause of SBP in a child. This unusual finding extends the spectrum of infectious diseases caused by Kocuria marina beyond the scope of the previously described susceptible population.

摘要

背景

自发性细菌性腹膜炎(SBP)在儿科人群中是一种罕见疾病。它通常在存在并发疾病时发生,如肾病综合征、腹膜透析或肝脏疾病。我们报告一例2岁无潜在危险因素儿童因海氏库克菌引起的自发性细菌性腹膜炎。这既是该罕见病原体在儿童中引起感染的首次描述,也是首例无易感因素患者由海氏库克菌引起的原发性腹膜炎报告病例。

病例介绍

一名2岁男孩因腹膜炎临床症状就诊于儿科急诊科。腹腔镜手术探查证实为化脓性、弥漫性腹膜炎,无穿孔。腹腔积液培养显示存在海氏库克菌,一种革兰氏阳性球状环境细菌。经过腹腔灌洗和适当的抗生素治疗,患者病情好转并出院,无后遗症。

结论

本报告阐述了无潜在危险因素儿童中海氏库克菌引起的SBP的首例临床表现。尽管此前在健康患者中从未有过描述,但该病原体因此可被视为儿童SBP的可能病因。这一不寻常的发现将海氏库克菌引起的传染病谱扩展到了先前描述的易感人群范围之外。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/4297396/8887e430c1c0/12879_2014_Article_719_Fig1_HTML.jpg

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