免疫功能正常患者原发性髂腰肌脓肿并发链球菌中毒性休克综合征的治疗：一例报告
Management of primary iliopsoas abscess in an immunocompetent patient followed by streptococcal toxic shock syndrome: A case report.
作者信息
Hirooka Nobutaka, Edo Naoki, Danbara Hisanori, Nishimura Hiroki, Obuchi Yasuhiro, Tanaka Yuji
机构信息
Department of General Medicine, National Defense Medical College, Tokorozawa, Japan.
出版信息
SAGE Open Med Case Rep. 2015 Mar 23;3:2050313X15575939. doi: 10.1177/2050313X15575939. eCollection 2015.
OBJECTIVES
Clinical diagnosis of iliopsoas abscess can be challenging, as this pathology often presents without obvious focal findings. Iliopsoas abscess should thus be a differential diagnosis for patients presenting with fever of unknown origin.
PATIENT AND METHODS
A 62-year-old healthy Japanese man showed primary iliopsoas abscess of Klebsiella pneumoniae complicated by shock after a complete course of treatment for streptococcal toxic shock syndrome. Successful treatment was achieved with culture-driven antibiotic selection and delayed drainage.
RESULTS
This case demonstrates the importance of identifying the causative microorganisms in iliopsoas abscess to guide therapy. The standard treatments for iliopsoas abscess are antibiotics and drainage of the abscess. Management of this case included successful antibiotic use along with delayed drainage.
CONCLUSION
This case report advances the knowledge on the etiology of iliopsoas abscess and sheds light on the need for scientific development of a treatment strategy.
目的
髂腰肌脓肿的临床诊断可能具有挑战性，因为这种病症常常没有明显的局部表现。因此，对于不明原因发热的患者，髂腰肌脓肿应作为鉴别诊断之一。
患者与方法
一名62岁健康日本男性，在接受链球菌中毒性休克综合征全程治疗后，出现了由肺炎克雷伯菌引起的原发性髂腰肌脓肿并伴有休克。通过培养驱动的抗生素选择和延迟引流实现了成功治疗。
结果
该病例证明了在髂腰肌脓肿中识别致病微生物以指导治疗的重要性。髂腰肌脓肿的标准治疗方法是使用抗生素和脓肿引流。该病例的治疗包括成功使用抗生素以及延迟引流。
结论
本病例报告增进了对髂腰肌脓肿病因的认识，并阐明了制定科学治疗策略的必要性。
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