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社区获得性产超广谱β-内酰胺酶所致的脊柱硬膜外脓肿

Spinal epidural abscess caused by a community acquired extended spectrum beta lactamase producing .

作者信息

Dang Vinh, Rajkumar Aarthi

机构信息

Department of Internal Medicine, Canton Medical Education Foundation & Aultman Hospital, 2600, 6th street SW, Canton, Ohio 44710, United States.

Department of Internal Medicine, North east Ohio Medical University (NEOMED), Canton Medical Education Foundation, 2600, 6th street SW, Canton, Ohio 44710, United States.

出版信息

IDCases. 2018 Aug 8;13:e00438. doi: 10.1016/j.idcr.2018.e00438. eCollection 2018.

Abstract

Spinal epidural abscess (SEA) can be a medical and surgical emergency. It is encountered in patients with epidural catheter placement, paraspinal injections, diabetes mellitus, alcoholism, HIV infection, trauma, contiguous bony or soft tissue infection, intravenous drug use, hemodialysis, or overt bacteremia, but may occur spontaneously associated with a presumed silent bacteremia. We report here, a case of extensive SEA due to a community-acquired extended spectrum beta lactamase (ESBL)-producing in a diabetic patient. This case highlights the importance of stringent antimicrobial stewardship and also the need for prompt diagnostic evaluation, and early surgical decompression in order to prevent morbidity and mortality.

摘要

脊髓硬膜外脓肿(SEA)可能是一种内科和外科急症。在进行硬膜外导管置入、椎旁注射、患有糖尿病、酗酒、感染HIV、遭受创伤、存在邻近骨或软组织感染、静脉吸毒、进行血液透析或有明显菌血症的患者中会遇到这种情况,但也可能在与推测的隐匿性菌血症相关的情况下自发发生。我们在此报告一例糖尿病患者因社区获得性产超广谱β-内酰胺酶(ESBL)而导致广泛SEA的病例。该病例凸显了严格抗菌管理的重要性,以及进行快速诊断评估和早期手术减压以预防发病和死亡的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/264f/6092525/4b47c7cf7a82/gr1.jpg

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