Pararajasingam Abirami, Uwagwu Juliet
Department of General Surgery, Lewisham and Greenwich NHS Trust, London, UK.
Department of Microbiology, Lewisham and Greenwich NHS Trust, London, UK.
BMJ Case Rep. 2017 Sep 13;2017:bcr-2016-218423. doi: 10.1136/bcr-2016-218423.
We present a 65-year-old diabetic patient with a complex liver abscess and bacteraemia from The abscess resulted in a prolonged hospital stay due to ongoing sepsis despite ultrasound-guided drainage and broad-spectrum antibiotics. Furthermore, the patient developed several secondary complications including a right-sided pleural effusion, an inferior vena cava thrombus and septic lung emboli. The abscess was eventually managed successfully with a prolonged course of antibiotics and multiple ultrasound-guided drainage procedures.To our knowledge, this is the first reported case of probiotic consumption, confirmed by strain identification, as the likely source of a liver abscess. Probiotic products have been widely used for many years and are advocated to the general public for their health benefits with no warning of side effects. Lactobacilli are one group of bacteria commonly used in these products. Although rare, complications have been reported. Susceptible patients, such as those who are immunocompromised, should be advised against excessive consumption.
我们报告了一名65岁的糖尿病患者，患有复杂的肝脓肿并伴有菌血症。尽管进行了超声引导下引流和使用了广谱抗生素，但由于持续的脓毒症，脓肿导致患者住院时间延长。此外，患者还出现了几种继发性并发症，包括右侧胸腔积液、下腔静脉血栓和脓毒性肺栓塞。最终，通过延长抗生素疗程和多次超声引导下引流手术，脓肿得到了成功治疗。据我们所知，这是首例经菌株鉴定证实益生菌摄入可能是肝脓肿来源的报告病例。益生菌产品已广泛使用多年，并因其对健康有益而向公众推广，且未警告有副作用。乳酸杆菌是这些产品中常用的一类细菌。虽然并发症很少见，但已有报道。对于易感患者，如免疫功能低下者，应建议避免过量食用。
