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一例早产儿暴发性肺坏死病例

A Case of Fulminant Lung Necrosis in a Preterm Neonate.

作者信息

Viel-Thériault Isabelle, Saban Jeremy, Lewis Alana, Bariciak Erika, Grynspan David

机构信息

Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

出版信息

Pediatr Dev Pathol. 2019 Oct;22(5):461-464. doi: 10.1177/1093526619825895. Epub 2019 Feb 13.

Abstract

is a ubiquitous Gram-positive rod seldom considered pathogenic in clinical isolates. However, it possesses multiple virulence factors explaining why it has been linked to fulminant and pyogenic infections in vulnerable hosts. Its recovery from sterile samples in immunocompromised patients cannot be disregarded. Premature infants would fall into this category. We describe the case of a neonate born at 26 weeks of gestational age, who died of a rapidly progressive necrotizing pneumonia following suspected nosocomial acquisition. The rapidity of his course and the autopsy findings of necrosis with minimal inflammation suggest a toxin-mediated process. Pathologists should be aware of this pathogen and obtain proper microbiological samples in the presence of such autopsy findings, as the diagnosis may have infection-prevention implications in health-care settings.

摘要

是一种普遍存在的革兰氏阳性杆菌,在临床分离株中很少被认为具有致病性。然而,它具有多种毒力因子,这解释了为什么它与易感宿主的暴发性和化脓性感染有关。免疫功能低下患者无菌样本中分离出该菌的情况不容忽视。早产儿就属于这一类别。我们描述了一例孕26周出生的新生儿病例,该患儿在疑似医院获得性感染后死于快速进展的坏死性肺炎。其病程的快速进展以及坏死且炎症轻微的尸检结果提示为毒素介导的过程。病理学家应了解这种病原体,并在出现此类尸检结果时获取适当的微生物样本,因为该诊断可能对医疗保健环境中的感染预防具有重要意义。

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