Kaito Satoshi, Sekiya Noritaka, Najima Yuho, Sano Naoki, Horiguchi Shinichiro, Kakihana Kazuhiko, Hishima Tsunekazu, Ohashi Kazuteru
Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Japan.
Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Japan.
Intern Med. 2018 Dec 15;57(24):3667-3671. doi: 10.2169/internalmedicine.1227-18. Epub 2018 Aug 10.
Although Stenotrophomonas maltophilia causes substantial morbidity and mortality in immunocompromised patients, it has not been described as a causal pathogen of neutropenic enterocolitis (NEC). We describe the first case of histologically-confirmed NEC caused by S. maltophilia accompanied by bacteremia and pneumonia after salvage chemotherapy for acute myeloid leukemia relapse following a second hematopoietic stem cell transplantation. S. maltophilia should be included as a pathogenic organism of NEC in severely immunocompromised patients to prevent a delayed diagnosis, which carries a high risk of inappropriate antimicrobial selection and fatal outcome.
虽然嗜麦芽窄食单胞菌在免疫功能低下的患者中会导致严重的发病和死亡,但它尚未被描述为中性粒细胞减少性小肠结肠炎(NEC)的致病病原体。我们描述了首例经组织学确诊的由嗜麦芽窄食单胞菌引起的NEC病例,该病例发生在第二次造血干细胞移植后急性髓系白血病复发进行挽救化疗后,同时伴有菌血症和肺炎。在严重免疫功能低下的患者中,应将嗜麦芽窄食单胞菌列为NEC的致病微生物,以防止延迟诊断,因为延迟诊断会带来抗菌药物选择不当和致命后果的高风险。