Yamanaka Yusuke, Shimabukuro Akira
Department of Family Medicine, Okinawa Miyako Hospital, Miyakojima, Okinawa, Japan.
Department of General Medicine, Okinawa Miyako Hospital, Miyakojima, Okinawa, Japan.
BMJ Case Rep. 2017 Aug 21;2017:bcr-2016-219135. doi: 10.1136/bcr-2016-219135.
A 43-year-old Japanese woman was evaluated in the outpatient department for right shoulder pain and fever, which began 5 days earlier. MRI of the right shoulder revealed a high-intensity area deep in the right trapezius muscle. Aspiration revealed purulent fluid, and Gram staining of the fluid showed Gram-negative bacilli. The patient was also found to be profoundly anaemic and to have a positive urine pregnancy test. On admission, we initiated intravenous ampicillin-sulbactam and aztreonam. She underwent dilatation and curettage for septic abortion and surgical drainage of the right shoulder abscess. was isolated from the blood, uterine aspiration and abscess samples. On hospital day 4, a whole-body CT scan revealed no other abscesses, and ampicillin-sulbactam was continued for 28 days. The patient was discharged on hospital day 29. Gram staining is an important tool for evaluating infectious aetiologies.
一名43岁的日本女性因5天前开始出现的右肩疼痛和发热在门诊接受评估。右肩MRI显示右斜方肌深处有一个高强度区域。穿刺抽出脓性液体，液体的革兰氏染色显示革兰氏阴性杆菌。该患者还被发现严重贫血且尿妊娠试验呈阳性。入院时，我们开始静脉注射氨苄西林-舒巴坦和氨曲南。她接受了刮宫术以治疗感染性流产，并对右肩脓肿进行了手术引流。从血液、子宫抽吸物和脓肿样本中分离出了[具体细菌名称未给出]。住院第4天，全身CT扫描未发现其他脓肿，氨苄西林-舒巴坦持续使用28天。患者于住院第29天出院。革兰氏染色是评估感染病因的重要工具。
