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拟态弧菌作为急性腹泻病的罕见病因

Vibrio Mimicus as the Rare Cause of Acute Diarrheal Illness.

作者信息

Muller Samuel, Chau Heather, Boudreaux Kristi

机构信息

Louisiana State University Health Services Center, New Orleans, LA.

出版信息

J La State Med Soc. 2016 Nov-Dec;168(6):192-193. Epub 2016 Dec 15.

Abstract

Vibrio mimicus, although named for having many of the same virulent factors as Vibrio cholera, is a rare cause of significant gastrointestinal illness. Like many of the Vibrio species, the strongest risk factor for V. mimicus infection is seafood consumption. After consuming crabs, a 64-year-old male presented with a three day history of voluminous, non-bloody, water diarrhea. The severity of the diarrhea caused the patient to have orthostatic hypotension and acute kidney injury, which improved with fluid resuscitation. The diarrhea resolved in 24-hours, and the patient was discharged without medications. Stool studies later returned positive for V. mimicus. Clinicians, especially those in coastal regions, should consider this rare pathogen in the setting of refractory diarrhea and a history significant for seafood consumption. With early clinical suspicion, clinicians can focus on volume repletion while limiting the use of anti-microbials.

摘要

拟态弧菌虽然因其具有许多与霍乱弧菌相同的致病因素而得名,但却是引起严重胃肠道疾病的罕见病因。与许多弧菌属物种一样,食用海鲜是拟态弧菌感染的最强风险因素。一名64岁男性在食用螃蟹后,出现了为期三天的大量、非血性水样腹泻。腹泻的严重程度导致患者出现体位性低血压和急性肾损伤,经液体复苏后病情好转。腹泻在24小时内缓解,患者未用药出院。粪便检查后来显示拟态弧菌呈阳性。临床医生,尤其是沿海地区的医生,在难治性腹泻且有食用海鲜史的情况下应考虑这种罕见病原体。有了早期临床怀疑,临床医生可以专注于补充液体量,同时限制使用抗菌药物。

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