Qian Yun, Wong Chi-Chun, Lai San-Chuan, Lin Zheng-Hua, Zheng Wei-Liang, Zhao Hui, Pan Kong-Han, Chen Shu-Jie, Si Jian-Min
Yun Qian, San-Chuan Lai, Zheng-Hua Lin, Shu-Jie Chen, Jian-Min Si, Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
World J Gastroenterol. 2016 Mar 7;22(9):2861-6. doi: 10.3748/wjg.v22.i9.2861.
We present a rare case of invasive liver abscess syndrome due to Klebsiella pneumoniae (K. pneumoniae) with metastatic meningitis and septic shock. A previously healthy, 55-year-old female patient developed fever, liver abscess, septic shock, purulent meningitis and metastatic hydrocephalus. Upon admission, the clinical manifestations, laboratory and imaging examinations were compatible with a diagnosis of K. pneumoniae primary liver abscess. Her distal metastasis infection involved meningitis and hydrocephalus, which could flare abruptly and be life threatening. Even with early adequate drainage and antibiotic therapy, the patient's condition deteriorated and she ultimately died. To the best of our knowledge, this is the first case of K. pneumoniae invasive liver abscess syndrome with septic meningitis reported in mainland China. Our findings reflect the need for a better understanding of the epidemiology, risk factors, complications, comorbid medical conditions and treatment of this disease.
我们报告一例罕见的由肺炎克雷伯菌引起的侵袭性肝脓肿综合征,伴有转移性脑膜炎和感染性休克。一名既往健康的55岁女性患者出现发热、肝脓肿、感染性休克、化脓性脑膜炎和转移性脑积水。入院时,临床表现、实验室检查和影像学检查均符合肺炎克雷伯菌原发性肝脓肿的诊断。她的远处转移感染累及脑膜炎和脑积水,病情可能突然恶化并危及生命。即使早期进行了充分的引流和抗生素治疗,患者的病情仍恶化,最终死亡。据我们所知,这是中国大陆首例报道的肺炎克雷伯菌侵袭性肝脓肿综合征合并化脓性脑膜炎的病例。我们的研究结果表明,需要更好地了解这种疾病的流行病学、危险因素、并发症、合并症及治疗方法。