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病例报告:由类鼻疽伯克霍尔德菌引起的脾脓肿。

A case report: Splenic abscess caused by Burkholderia pseudomallei.

作者信息

Chen Hai, Hu Zhi-Qiang, Fang Yao, Lu Xiao-Xue, Li Li-da, Li Yuan-Li, Mao Xu-Hu, Li Qian

机构信息

Department of Clinical Laboratory, People's Hospital of Sanya, Sanya City, Hainan Province Department of Clinical Microbiology and Immunology, College of Medical Laboratory Science, Third Military Medical University (Army Medical University), Chongqing, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(26):e11208. doi: 10.1097/MD.0000000000011208.

Abstract

RATIONALE

Melioidosis is an emerging infectious disease caused by Burkholderia pseudomallei. To our knowledge, there have been very few cases of splenic abscesses due to melioidosis in Hainan, China.

PATIENT CONCERNS

The patient was a 55-year-old male farmer, who was admitted in our hospital with persistent left epigastric dull pain accompanied by chills and febrile. One month before, the patient presented with persistent abdominal pain. After received anti-infection therapy, the subjective symptoms eased slightly, but recently he suffered from intermittent abdominal pain again.

DIAGNOSES

Bacteria isolated from splenic pus were identified as B. pseudomallei by the Phoenix-100 system and indirect immunofluorescence.

INTERVENTIONS

The patient was treated by surgical excision and anti-infection therapy.

OUTCOMES

The patient was then treated with intravenous ceftazidime and oral trimethoprim-sulfamethoxazole for 2 weeks and his clinical symptoms improved.

LESSONS

In endemic areas, B. pseudomallei should be considered as a causative organism of splenic abscess in patients with established risk factors. The isolation of B. pseudomallei from abscess sites is crucial to improve clinical outcomes by appropriate antimicrobial therapy coupled with surgical drainage.

摘要

原理

类鼻疽是由类鼻疽伯克霍尔德菌引起的一种新发传染病。据我们所知,在中国海南,由类鼻疽引起的脾脓肿病例非常少。

患者情况

患者为一名55岁男性农民,因持续性左上腹隐痛伴寒战、发热入院。一个月前,患者出现持续性腹痛。接受抗感染治疗后,主观症状稍有缓解,但最近又出现间歇性腹痛。

诊断

通过Phoenix-100系统和间接免疫荧光法,从脾脓中分离出的细菌被鉴定为类鼻疽伯克霍尔德菌。

干预措施

患者接受了手术切除和抗感染治疗。

结果

随后患者接受静脉注射头孢他啶和口服复方新诺明治疗2周,临床症状改善。

经验教训

在流行地区,对于有既定危险因素的患者,应将类鼻疽伯克霍尔德菌视为脾脓肿的致病菌。从脓肿部位分离出类鼻疽伯克霍尔德菌对于通过适当的抗菌治疗结合手术引流改善临床结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7b1/6039618/cd386e5f1464/medi-97-e11208-g002.jpg

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