Inagaki Ayane, Moriyama Yuki, Morioka Shinichiro, Wakimoto Yuji, Shida Yoshitaka, Ohmagari Norio
Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.
Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.
J Infect Chemother. 2019 Jun;25(6):470-472. doi: 10.1016/j.jiac.2019.01.001. Epub 2019 Feb 14.
We herein report a case of Klebsiella pneumoniae (K. pneumoniae) spondylitis and bacteremia in a 90-year-old man with diabetes mellitus who had undergone sigmoidectomy and had a fecalith. Two months prior to admission, he had received antimicrobial treatment for 2 weeks for K. pneumoniae bacteremia whose entry was unclear and he was readmitted to our hospital owing to fever and stomachache. K. pneumoniae was isolated from two sets of blood cultures, and computed tomography and magnetic resonance imaging revealed inflammation and destruction of the 8th and 9th thoracic vertebra. The diagnosis was spondylodiscitis secondary to K. pneumoniae bacteremia. Although the entry point for K. pneumoniae was unclear, we suggest that inflammation of the mucosa around the fecalith might have caused the Enterobacteriaceae bacteremia.
我们在此报告一例90岁患糖尿病的男性肺炎克雷伯菌性脊柱炎和菌血症病例，该患者接受过乙状结肠切除术且有粪石。入院前两个月，他因肺炎克雷伯菌菌血症接受了2周的抗菌治疗，菌血症的感染源不明，后因发热和腹痛再次入住我院。从两组血培养中分离出肺炎克雷伯菌，计算机断层扫描和磁共振成像显示第8和第9胸椎有炎症和破坏。诊断为肺炎克雷伯菌菌血症继发的脊椎椎间盘炎。尽管肺炎克雷伯菌的感染源不明，但我们认为粪石周围的黏膜炎症可能导致了肠杆菌科菌血症。
