Ferraz de Campos Fernando Peixoto, Felipe-Silva Aloísio, Lopes Ana Claudia Frota Machado de Melo, Passadore Lilian Ferri, Guida Stella Maria, Balabakis Angélica Jean, Martines João Augusto Dos Santos
Department of Internal Medicine - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Autops Case Rep. 2014 Sep 30;4(3):31-37. doi: 10.4322/acr.2014.026. eCollection 2014 Jul-Sep.
Although the infection is well known and frequently found in hospitals and nursing care facilities, many cases are also reported outside these boundaries. In general, this pathogen infects debilitated patients either by comorbidities or by any form of immunodeficiency. In cases of respiratory infection, tobacco abuse seems to play an important role as a risk factor. In previously healthy patients, community-acquired pneumonia (CAP) with as the etiological agent is extremely rare, and unlike the cases involving immunocompromised or hospitalized patients, the outcome is severe, and is fatal in up to 61.1% of cases. Aerosolized contaminated water or solutions are closely linked to the development of respiratory tract infection. In this setting, metalworking fluids used in factories may be implicated in CAP involving previously healthy people. The authors report the case of a middle-aged man who worked in a metalworking factory and presented a right upper lobar pneumonia with a rapid fatal outcome. was cultured from blood and tracheal aspirates. The autopsy findings confirmed a hemorrhagic necrotizing pneumonia with bacteria-invading vasculitis and thrombosis. A culture of the metalworking fluid of the factory was also positive for . The pulsed-field gel electrophoresis showed that both strains (blood culture and metalworking fluid) were genetically indistinguishable. The authors highlight the occupational risk for the development of this infection in healthy people.
虽然这种感染广为人知且在医院和护理机构中经常出现,但在这些场所之外也有许多病例报告。一般来说,这种病原体通过合并症或任何形式的免疫缺陷感染身体虚弱的患者。在呼吸道感染病例中,吸烟似乎作为一个危险因素发挥着重要作用。在既往健康的患者中,由[病原体名称未给出]作为病原体引起的社区获得性肺炎(CAP)极为罕见,并且与涉及免疫功能低下或住院患者的病例不同,其后果严重,高达61.1%的病例会死亡。雾化的受污染水或溶液与呼吸道感染的发生密切相关。在这种情况下,工厂中使用的金属加工液可能与涉及既往健康人群的CAP有关。作者报告了一名在金属加工厂工作的中年男子的病例,该男子出现了右上叶肺炎并迅速死亡。[病原体名称未给出]从血液和气管吸出物中培养出来。尸检结果证实为出血性坏死性肺炎,伴有细菌侵袭性血管炎和血栓形成。工厂的金属加工液培养物对[病原体名称未给出]也呈阳性。脉冲场凝胶电泳显示两种菌株(血培养和金属加工液)在基因上无法区分。作者强调了健康人群发生这种感染的职业风险。