Khalil Abdalla, Qurash Musaad, Saleh Asem, Ali Rasha, Elwakil Mohamed
Internal Medicine Department, International Medical Center (IMC) Hospital, Jeddah, Saudi Arabia.
Radiology Department, IMC Hospital, Jeddah, Saudi Arabia.
Case Rep Infect Dis. 2016;2016:9076813. doi: 10.1155/2016/9076813. Epub 2016 Nov 27.
Extended-spectrum beta-lactamase-producing Enterobacteriaceae urinary tract infections are challenging infections with increased mortality, morbidity, and failure of therapy. A 44-year-old Saudi male diabetic patient was seen at the ER of IMC Hospital with features of acute pyelonephritis: fever, burning urine, and left flank pain for three days. He was treated for cystitis at the Endocrine Clinic two weeks prior to his ER visit with nitrofurantoin and levofloxacin orally according to urine culture and sensitivity result. The patient was admitted, received IV meropenem, and continued to be febrile for three days. His urine and blood culture at ER grew the same ESBL-producing as in his urine culture from the Endocrine Clinic. His abdomen CT scan showed two left renal abscesses at the upper and middle poles. His temperature resolved on the fourth day of IV therapy. Intravenous meropenem was continued for 4 weeks after inserting PICC line and the patient was followed up by home healthcare. He was feeling better with occasional left flank pain and repeated abdomen CT scan showed complete resolution of both renal abscesses.
产超广谱β-内酰胺酶肠杆菌科细菌引起的尿路感染是具有挑战性的感染，会导致死亡率上升、发病率增加以及治疗失败。一名44岁的沙特男性糖尿病患者因急性肾盂肾炎症状前往IMC医院急诊室就诊：发热、尿痛以及左侧胁腹疼痛三天。在此次急诊就诊前两周，他在内分泌诊所因膀胱炎接受治疗，根据尿培养和药敏结果口服呋喃妥因和左氧氟沙星。患者入院后接受了静脉注射美罗培南治疗，但持续发热三天。他在急诊室的尿液和血液培养结果与在内分泌诊所的尿培养中生长出的产超广谱β-内酰胺酶细菌相同。他的腹部CT扫描显示左肾上下极有两个肾脓肿。在静脉治疗的第四天体温恢复正常。插入PICC导管后继续静脉注射美罗培南4周，患者由家庭医疗保健机构进行随访。他感觉好转，偶尔有左侧胁腹疼痛，重复进行的腹部CT扫描显示两个肾脓肿均已完全消退。
