免疫球蛋白 G2 缺陷患者的无肝脓肿高黏液化脓性克雷伯菌综合征。
Hypermucoviscous Klebsiella syndrome without liver abscess in a patient with immunoglobulin g2 immune deficiency.
机构信息
Departments of Internal Medicine ; Medical Microbiology.
Departments of Internal Medicine.
出版信息
Open Forum Infect Dis. 2014 Sep 9;1(2):ofu080. doi: 10.1093/ofid/ofu080. eCollection 2014 Sep.
BACKGROUND
Hypermucoviscous Klebsiella pneumoniae (HMVKP) emerged as a cause of invasive infections in South-East (SE) Asia. It has become the most common cause of liver abscess in that region, and it is a significant causative organism in endogenous endophthalmitis and meningitis. During the past decade, cases of this uniquely virulent organism have been reported outside of SE Asia, with a propensity to affect individuals of SE Asian descent. Cases have been reported from North America including Canada.
METHODS
We report a case of a patient of Filipino descent living in Canada who presented with recurrent HMVKP bacteremia in the absence of pyogenic liver abscess or other localized metastatic Klebsiella infection.
RESULTS
Investigations identified an immunoglobulin (Ig)G2 deficiency and low IgM indicating potential common variable immunodeficiency, and administration of intravenous immunoglobulins was associated with prevention of further recurrences.
CONCLUSIONS
To our knowledge, this is the first report of HMVKP associated with predisposing antibody deficiency.
背景
高黏液型肺炎克雷伯菌（HMVKP）已成为东南亚侵袭性感染的一个病因。它已成为该地区肝脓肿的最常见病因，也是内源性眼内炎和脑膜炎的重要病原体。在过去十年中，这种具有独特毒力的病原体已在东南亚以外地区报告，其倾向于影响东南亚裔个体。包括加拿大在内的北美地区也有病例报告。
方法
我们报告了一例菲律宾裔加拿大居民的病例，该患者在无化脓性肝脓肿或其他局部转移性肺炎克雷伯菌感染的情况下，出现反复发作的 HMVKP 菌血症。
结果
检查发现 IgG2 缺乏和 IgM 降低，提示潜在的普通可变免疫缺陷，静脉注射免疫球蛋白的给予与预防进一步复发相关。
结论
据我们所知，这是首例与易感性抗体缺陷相关的 HMVKP 报告。
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