Tanaka Hidekazu, Watanabe Tomohiro, Nagai Tomoyuki, Minaga Kosuke, Kamata Ken, Komeda Yoriaki, Kudo Masatoshi
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Clin J Gastroenterol. 2019 Aug;12(4):316-319. doi: 10.1007/s12328-019-00947-1. Epub 2019 Feb 9.
Klebsiella oxytoca (K. oxytoca) is a causative organism for hemorrhagic antibiotic-associated colitis. K. oxytoca infection is a typical example of microbial substitution diseases caused by exposure to antibiotics prior to the onset of diarrhea. Here, we repot a case with ileitis associated with K. oxytoca infection in the absence of preceding antibiotic treatment. Interestingly, abdominal computed tomography revealed wall thickening of the ileum and hepatic portal venous gas (HPVG). K. oxytoca was isolated from the stool. This very elderly patient had been treated with azathioprine for long-standing history of ulcerative colitis. Immuno-compromised state of this patient was considered to allow overgrowth of K. oxytoca in the small bowel to cause not only ileitis but also HPVG.
产酸克雷伯菌（K. oxytoca）是出血性抗生素相关性结肠炎的致病微生物。产酸克雷伯菌感染是腹泻发作前接触抗生素引起的微生物替代疾病的典型例子。在此，我们报告一例在无先前抗生素治疗情况下与产酸克雷伯菌感染相关的回肠炎病例。有趣的是，腹部计算机断层扫描显示回肠壁增厚和肝门静脉积气（HPVG）。从粪便中分离出产酸克雷伯菌。这位高龄患者因长期溃疡性结肠炎病史一直接受硫唑嘌呤治疗。该患者的免疫功能低下状态被认为使得产酸克雷伯菌在小肠过度生长，不仅导致回肠炎，还引发了肝门静脉积气。
