与糖尿病控制不佳相关的危及生命的气肿性肝脓肿：一例报告
Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report.
作者信息
Takano Yuichi, Hayashi Masafumi, Niiya Fumitaka, Nakanishi Toru, Hanamura Shotaro, Asonuma Kunio, Yamamura Eiichi, Gomi Kuniyo, Kuroki Yuichiro, Maruoka Naotaka, Inoue Kazuaki, Nagahama Masatsugu
机构信息
Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan.
出版信息
BMC Res Notes. 2017 Mar 6;10(1):117. doi: 10.1186/s13104-017-2445-8.
BACKGROUND
Emphysematous liver abscesses are defined as liver abscesses accompanied by gas formation. The fatality rate is extremely high at 27%, necessitating prompt intensive care.
CASE PRESENTATION
The patient was a 69-year-old Japanese man with type 2 diabetes. He visited the emergency outpatient department for fever and general malaise that had been ongoing for 2 weeks. Abdominal computed tomography revealed an abscess 5 cm in diameter accompanied by gas formation in the right hepatic lobe. Markedly impaired glucose tolerance was observed with a blood sugar level of 571 mg/dL and a glycated hemoglobin level of 14.6%. The patient underwent emergency percutaneous abscess drainage, and intensive care was subsequently initiated. Klebsiella pneumoniae was detected in both the abscess cavity and blood cultures. The drain was removed 3 weeks later, and the patient was discharged.
CONCLUSION
Emphysematous liver abscesses are often observed in patients with poorly controlled diabetes, and the fatality rate is extremely high. Fever and malaise occasionally mask life-threatening infections in diabetic patients, necessitating careful examination.
背景
气肿性肝脓肿定义为伴有气体形成的肝脓肿。其死亡率极高，达27%，因此需要及时进行重症监护。
病例报告
患者为一名69岁的日本男性，患有2型糖尿病。他因持续两周的发热和全身乏力前往急诊门诊部就诊。腹部计算机断层扫描显示右肝叶有一个直径5厘米的脓肿并伴有气体形成。观察到明显的糖耐量受损，血糖水平为571毫克/分升，糖化血红蛋白水平为14.6%。患者接受了紧急经皮脓肿引流，随后开始进行重症监护。在脓肿腔和血培养中均检测到肺炎克雷伯菌。3周后拔除引流管，患者出院。
结论
气肿性肝脓肿常见于糖尿病控制不佳的患者，死亡率极高。发热和乏力有时会掩盖糖尿病患者危及生命的感染，因此需要仔细检查。
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