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侵袭性腐败坏死埃肯菌致严重化脓性心包炎 1 例并文献复习

Severe purulent pericarditis caused by invasive Eikenella corrodens: case report and literature review.

机构信息

Emergency Department of West China Hospital, Sichuan University, Chengdu, China.

出版信息

BMC Infect Dis. 2019 Jul 23;19(1):657. doi: 10.1186/s12879-019-4256-0.

Abstract

BACKGROUND

Eikenella corrodens is a slowly growing gram-negative bacillus that can cause severe invasive disease in human. Although E. corrodens infections in various sites of human body have been well described, pericarditis caused by invasive E. corrodens has rarely been reported.

CASE PRESENTATION

Here we report the case of a 63-year old male with a complaint of left shoulder pain. The patient was diagnosed as purulent pericarditis by chest computed tomography scan and ultrasound-guided pericardiocentesis, and the pathogen of E. corrodens was identified in the pericardial fluid culture. The clinical condition of the patient deteriorated quickly, and he died right after the drainage surgery even though the pathogen was sensitive to antibiotics treatment.

CONCLUSION

E. corrodens is a rare pericarditis associated pathogen. Purulent pericarditis caused by E. corrodens presents atypical manifestations and rapid progression of infection in immunosuppressed individuals such as neutropenic patients. Earlier diagnosis and proper drainage surgery with effective antibiotics treatment may improve the prognosis.

摘要

背景

侵蚀艾肯菌是一种生长缓慢的革兰氏阴性杆菌,可导致人类严重的侵袭性疾病。尽管已充分描述了人体各种部位的侵蚀艾肯菌感染,但侵袭性侵蚀艾肯菌引起的心包炎却很少见。

病例介绍

本研究报告了一例 63 岁男性患者,主诉左肩痛。患者经胸部 CT 扫描和超声引导下心包穿刺诊断为化脓性心包炎,在心包液培养中鉴定出侵蚀艾肯菌。尽管病原体对抗生素治疗敏感,但患者的临床状况迅速恶化,引流手术后即死亡。

结论

侵蚀艾肯菌是一种罕见的心包炎相关病原体。在中性粒细胞减少等免疫抑制个体中,由侵蚀艾肯菌引起的化脓性心包炎表现为非典型症状和感染的快速进展。早期诊断和适当的引流手术结合有效的抗生素治疗可能改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ea/6651983/4d0f3a3a6487/12879_2019_4256_Fig1_HTML.jpg

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