Szaniawski Matthew Alan, Spivak Adam Mitchell
Department of Medicine, University of Utah School of Medicine, East Salt Lake City, UT 84132, USA.
Oxf Med Case Reports. 2019 May 31;2019(5):omz034. doi: 10.1093/omcr/omz034. eCollection 2019 May.
The genus includes Gram-positive bacteria that are rarely known to cause infection in humans. Here we report a case of recurrent infection in an otherwise healthy 66-year-old man following environmental exposure decades prior to presentation to our clinic. Despite numerous attempts at surgical debridement, was repeatedly cultured from the soft tissue of the lower extremity wound site over a period of years. Post-operative antibiotic treatment prevented recurrence; however, upon antibiotic discontinuation, was again cultured from the wound. After multiple rounds of debridement and antibiotic therapy, the patient was started on indefinite, low-dose trimethoprim-sulfamethoxazole therapy to suppress infection resulting from transition of spores to vegetative cells. This case adds to the limited number of case reports describing species infection in healthy adults and presents a unique case of bona fide infection requiring life-long antibiotic therapy.
该属包括革兰氏阳性菌，这类细菌很少引起人类感染。在此，我们报告一例66岁健康男性在就诊前数十年因环境暴露后发生反复感染的病例。尽管多次尝试进行手术清创，但在数年时间里，该菌反复从下肢伤口部位的软组织中培养出来。术后抗生素治疗可预防复发；然而，停用抗生素后，伤口中又培养出了该菌。经过多轮清创和抗生素治疗后，患者开始接受无限期、低剂量的甲氧苄啶-磺胺甲恶唑治疗，以抑制因该菌孢子转变为营养细胞而导致的感染。该病例增加了描述健康成年人感染该菌属物种的有限病例报告数量，并呈现了一例需要终身抗生素治疗的真正感染的独特病例。
