Langguth Patrick, Leissner Lothar, Zick Günther, Fischer Arno, Stuhlmann-Laiesz Christiane, Salehi Ravesh Mona, Austein Friederike, Jansen Olav, Both Marcus
Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany.
Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
Case Rep Infect Dis. 2018 Aug 2;2018:3870640. doi: 10.1155/2018/3870640. eCollection 2018.
(CC) belongs to the family Flavobacteriaceae which physiologically occurs in the natural flora of the oral mucosa of dogs and cats. In patients with a compromised immune system, CC can induce a systemic infection with a fulminant course of disease. Infections with CC are rare, and the diagnosis is often complicated and prolonged. We describe a patient with a medical history of prior splenectomy who presented with an acute sepsis and disseminated intravascular coagulation (DIC) and was initially treated on Waterhouse-Friderichsen syndrome (WFS). After the patient had died despite forced treatment in the intermediate care unit, the differential diagnosis of CC was confirmed by culture of blood smears. Later on, a retrospective third-party anamnesis revealed that the patient had contact to his neighbour's dog a few days before disease onset. In conclusion, patients with CC infection can mimic WFS and therefore must be included in the differential diagnosis, especially in patients with a corresponding medical history of dog or cat bites, scratches, licks, or simple exposure.
嗜麦芽窄食单胞菌属于黄杆菌科，在生理上存在于犬猫口腔黏膜的自然菌群中。在免疫系统受损的患者中，嗜麦芽窄食单胞菌可引发具有暴发性病程的全身感染。嗜麦芽窄食单胞菌感染较为罕见，诊断往往复杂且耗时。我们描述了一名有脾切除病史的患者，该患者出现急性脓毒症和弥散性血管内凝血（DIC），最初按照华-弗综合征（WFS）进行治疗。尽管在中级护理病房进行了积极治疗，患者仍死亡，血涂片培养确诊了嗜麦芽窄食单胞菌的鉴别诊断。后来，回顾性第三方病史调查显示，患者在发病前几天与邻居的狗有过接触。总之，嗜麦芽窄食单胞菌感染患者可能类似华-弗综合征，因此必须纳入鉴别诊断，尤其是有相应犬猫咬伤、抓伤、舔舐或简单接触病史的患者。
