Kawakami Toru, Nakazawa Hideyuki, Kurasawa Yukifumi, Sakai Hitoshi, Nishina Sayaka, Senoo Noriko, Senoo Yasushi, Ishida Fumihiro
Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Japan.
Division of Nephrology, Department of Internal Medicine, Shinshu University School of Medicine, Japan.
Intern Med. 2018 Jan 1;57(1):127-130. doi: 10.2169/internalmedicine.9151-17. Epub 2017 Oct 11.
Eculizumab is the complement inhibitor administered to ameliorate intravascular hemolysis in paroxysmal nocturnal hemoglobinuria. Whether or not the inhibitory mechanism may also increase the susceptibility to non-Neisserial infection is unclear. A 73-year old woman presented with bacteremia, cholecystitis and liver abscess with Pseudomonas aeruginosa. Although she had been neutropenic for 21 years, she had no history of severe infection before eculizumab had been administered. The infection with P. aeruginosa was successfully controlled with antibiotics, granulocyte colony-stimulating factor and cholecystectomy. The present case might be representative of less common bacterial infections than Neisseria spp. among patients treated with eculizumab.
依库珠单抗是一种补体抑制剂，用于改善阵发性夜间血红蛋白尿中的血管内溶血。其抑制机制是否也会增加非奈瑟菌感染的易感性尚不清楚。一名73岁女性出现铜绿假单胞菌引起的菌血症、胆囊炎和肝脓肿。尽管她已经中性粒细胞减少21年，但在使用依库珠单抗之前没有严重感染史。铜绿假单胞菌感染通过抗生素、粒细胞集落刺激因子和胆囊切除术成功得到控制。本病例可能代表了依库珠单抗治疗患者中比奈瑟菌属更少见的细菌感染。
