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伊朗东北部一例致命性胃肠型炭疽病例。

A case of fatal gastrointestinal anthrax in north eastern iran.

作者信息

Hashemi Seyed Ahmad, Azimian Amir, Nojumi Sara, Garivani Tahereh, Safamanesh Saghar, Ghafouri Majid

机构信息

Department of Infectious Diseases, Emam Reza Hospital, North Khorasan University of Medical Sciences, Bojnurd 74877-94149, Iran.

Department of Pathobiology and Anatomy, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd 74877-94149, Iran ; Medical Diagnostic Laboratory, Emam Reza Hospital, North Khorasan University of Medical Sciences, Bojnurd 74877-94149, Iran.

出版信息

Case Rep Infect Dis. 2015;2015:875829. doi: 10.1155/2015/875829. Epub 2015 Mar 31.

Abstract

Background. Bacillus species are aerobic or facultative anaerobic, gram-positive, or gram-variable spore-forming rods. They are ubiquitous in the environmental sources. Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal, and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. In this paper we report septic intestinal anthrax. Case Presentation. We report an isolation of Bacillus anthracis from blood culture of patient with intestinal anthrax. Bacillus anthracis was isolated from a blood culture of a 34-year-old man who had a history of severe abdominal pain, bloody diarrhea, nausea, vomiting, fever, sweating, and lethargy within 4 to 5 days after eating the meat of domestic goat. He had evidence of severe infection and septic shock and did not respond to treatments and subsequently expired 9 hours after hospitalization. Conclusion. Gastrointestinal anthrax is characterized by rapid onset, fever, and septicemia. Rapid diagnosis and prompt initiation of antibiotic therapy can help in survival. Most of previous cases of septicemic anthrax were related to injection drug users but, in our case, septicemia occurred after gastrointestinal anthrax.

摘要

背景。芽孢杆菌属为需氧或兼性厌氧、革兰氏阳性或革兰氏可变的产芽孢杆菌。它们在环境来源中普遍存在。炭疽芽孢杆菌通常可引起三种形式的炭疽:吸入性、胃肠道性和皮肤性。胃肠道炭疽在食用受污染肉类后发病。本文报告了败血症型肠道炭疽病例。病例报告。我们报告了从一名肠道炭疽患者的血培养物中分离出炭疽芽孢杆菌。炭疽芽孢杆菌是从一名34岁男性的血培养物中分离出来的,该男子在食用家山羊肉后4至5天内出现严重腹痛、血性腹泻、恶心、呕吐、发热、出汗和嗜睡症状。他有严重感染和感染性休克的迹象,对治疗无反应,随后在住院9小时后死亡。结论。胃肠道炭疽的特点是起病迅速、发热和败血症。快速诊断并及时开始抗生素治疗有助于患者存活。以前大多数败血症型炭疽病例与注射吸毒者有关,但在我们的病例中,败血症发生在胃肠道炭疽之后。

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