Nakazawa Hideyuki, Nishina Sayaka, Sakai Hitoshi, Ito Toshiro, Ishida Fumihiro, Kitano Kiyoshi
Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Japan.
Department of Hematology, NHO Matsumoto Medical Center, Japan.
Intern Med. 2018 Nov 15;57(22):3329-3332. doi: 10.2169/internalmedicine.1031-18. Epub 2018 Jul 6.
Asplenia may yield an increased risk of fulminant sepsis with various pathogens. Human infection with Campylobacter fetus is rare, but it often presents with non-gastrointestinal tract infection among immunocompromised individuals. A 55-year-old abattoir worker presented with a fever. He had had splenectomy for follicular lymphoma and rituximab maintenance therapy by four months before the presentation. Blood cultures yielded C. fetus, and the administration of meropenem dissolved the bacteremia. Further maintenance therapy was withheld, and no recurrence of infection has been observed for seven years. Asplenia, occupational exposure, and/or rituximab maintenance therapy might have been precipitating factors of this rare infection.
无脾可能会增加感染各种病原体导致暴发性败血症的风险。人感染胎儿弯曲杆菌很罕见,但在免疫功能低下的个体中常表现为非胃肠道感染。一名55岁的屠宰场工人出现发热症状。他因滤泡性淋巴瘤接受了脾切除术,并在出现症状前四个月接受了利妥昔单抗维持治疗。血培养发现胎儿弯曲杆菌,美罗培南治疗消除了菌血症。停止了进一步的维持治疗,七年来未观察到感染复发。无脾、职业暴露和/或利妥昔单抗维持治疗可能是这种罕见感染的诱发因素。