Yamazaki Tomoo, Joshita Satoru, Kasuga Eriko, Horiuchi Kazuki, Sugiura Ayumi, Fujimori Naoyuki, Komatsu Michiharu, Umemura Takeji, Matsumoto Akihiro, Tanaka Eiji
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan; Research Center for Next Generation Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
J Infect Chemother. 2018 May;24(5):393-397. doi: 10.1016/j.jiac.2017.11.006. Epub 2017 Dec 18.
A 73-year-old woman was admitted with consciousness disturbance following a fever. Abdominal computed tomography revealed a large liver abscess with which the presence of Desulfovibrio desulfuricans and Escherichia coli was confirmed by thorough blood and abscess content culture. Empiric meropenem treatment was switched to cefoperazone/sulbactam, followed by ampicillin/sulbactam based on susceptibility testing. Desulfovibrio desulfuricans is a common bacterium that rarely causes liver abscess and may be overlooked during co-infection due to overgrowth of the accompanying bacteria. Clinicians should bear Desulfovibrio desulfuricans in mind and select the appropriate antibiotics according to susceptibility testing when anaerobic bacteria are detected in a liver abscess.
一名73岁女性因发热后出现意识障碍入院。腹部计算机断层扫描显示一个大的肝脓肿，通过对血液和脓肿内容物进行全面培养，证实存在脱硫脱硫弧菌和大肠杆菌。经验性美罗培南治疗改为头孢哌酮/舒巴坦，随后根据药敏试验改为氨苄西林/舒巴坦。脱硫脱硫弧菌是一种常见细菌，很少引起肝脓肿，在合并感染时可能因伴发细菌过度生长而被忽视。临床医生在肝脓肿中检测到厌氧菌时，应牢记脱硫脱硫弧菌，并根据药敏试验选择合适的抗生素。
