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产超广谱β-内酰胺酶的输卵管卵巢脓肿急诊手术:首例揭示病原菌的病例报告

Emergency surgery for tubo-ovarian abscess identified extended-spectrum beta-lactamase-producing : the first case presentation revealing causative bacteria.

作者信息

Tokumaru Teppei, Shima Yasuo, Okabayashi Takehiro, Hayashi Kazutoshi, Yamamoto Yorito, Ozaki Kazuhide, Iwata Jun

机构信息

Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi 781-8555 Japan.

Department of Obstetrics and Gynecology, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi 781-8555 Japan.

出版信息

Surg Case Rep. 2015;1(1):66. doi: 10.1186/s40792-015-0069-6. Epub 2015 Aug 15.

Abstract

We report herein a 41-year-old female with a tubo-ovarian abscess (TOA), which microbial cultures showed to contain extended-spectrum beta-lactamase (ESBL)-producing a causative agent of community-acquired infection. The patient initially presented with acute abdominal pain and back pain. Pelvic computed tomography and transvaginal ultrasonography revealed multiple cystic lesions in the bilateral ovaries that suggested TOA. An emergency laparotomy was therefore performed due to the potential for life-threatening septic shock from the TOA-associated pelvic inflammatory disease. Microbial cultures of postoperative fluid discharge from the placed intra-abdominal catheter, vaginal secretions, urine, blood, and feces detected ESBL-producing In summary, we successfully performed emergency surgery for life-threatening septic TOA caused by ESBL-producing infection.

摘要

我们在此报告一名41岁患有输卵管卵巢脓肿(TOA)的女性,微生物培养显示其含有产超广谱β-内酰胺酶(ESBL)的病原体,这是一种社区获得性感染的病原体。患者最初表现为急性腹痛和背痛。盆腔计算机断层扫描和经阴道超声检查显示双侧卵巢有多个囊性病变,提示为TOA。由于TOA相关的盆腔炎有导致危及生命的感染性休克的可能性,因此进行了急诊剖腹手术。对放置的腹腔内导管术后引流液、阴道分泌物、尿液、血液和粪便进行的微生物培养检测出产ESBL的病原体。总之,我们成功地对由产ESBL病原体感染引起的危及生命的感染性TOA进行了急诊手术。

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