Juma Fatema, Cave Joshua J, Gonzales Hector, Moore Luke Stephen Prockter
London North West University Healthcare NHS Trust , Harrow, UK.
Department of General Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK.
BMJ Case Rep. 2019 Jul 19;12(7):e230186. doi: 10.1136/bcr-2019-230186.
Non-typhoidal are Gram-negative bacilli, which typically cause a clinical picture of gastroenteritis and, less commonly, patients may become a chronic carrier of the pathogen within their gallbladder. We describe a rare clinical presentation of a non-typhoidal infection as acute calculus cholecystitis in an adult patient. subsp. Salamae (ST P4271) was grown from cholecystostomy fluid, and the patient subsequently underwent a laparoscopic cholecystectomy that demonstrated a necrotic gallbladder fundus. We advise that microbiological sampling of bile is essential, especially in the context of foreign travel, to detect unusual pathogens as in this case or common pathogens that may have unusual antimicrobial resistance. Given the necrotic gallbladder as in this case, we also advise that early cholecystectomy should be strongly considered in these patients.
非伤寒型是革兰氏阴性杆菌,通常会引起肠胃炎的临床表现,较少见的是,患者可能会成为胆囊内该病原体的慢性携带者。我们描述了一名成年患者罕见的非伤寒型感染临床表现为急性结石性胆囊炎。从胆囊造瘘液中培养出了萨拉马埃亚种(ST P4271),该患者随后接受了腹腔镜胆囊切除术,术中发现胆囊底部坏死。我们建议,胆汁的微生物采样至关重要,尤其是在有国外旅行史的情况下,以检测此类不寻常病原体或可能具有不寻常抗菌耐药性的常见病原体。鉴于本例中出现的胆囊坏死情况,我们还建议对这些患者应强烈考虑早期进行胆囊切除术。