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一例罕见的以胆汁性脓毒症形式出现的戴维斯西地西菌血症病例。

A Rare Case of Cedecea Davisae Bacteremia Presenting as Biliary Sepsis.

作者信息

Kanakadandi Venkata Sowjanya, Sarao Manbeer S, Cunningham Jessica M

机构信息

Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, USA.

Internal Medicine, Griffin Hospital, Derby, USA.

出版信息

Cureus. 2019 Aug 1;11(8):e5298. doi: 10.7759/cureus.5298.

Abstract

Cedecea davisae is a gram-negative, non-sporulating motile rod-shaped bacteria of the Enterobacteriaceae family. It is an opportunistic pathogen in advanced-aged patients with many comorbid diseases and the immunosuppressed. To the best of our knowledge, only 12 cases of C. davisae bacteremia have been reported in the literature. Here we discuss the 13th case of C. davisae bacteremia, which is the first reported case presenting as biliary sepsis. A 41-year-old female, on prednisone for minimal change disease, presented with nausea, vomiting, fever, and diarrhea. She had dry mucous membranes, scleral icterus, and elevated liver enzymes. Blood cultures revealed Cedecea davisae. She improved after management with broad-spectrum antibiotics. Further studies are needed to understand its role in the mode of transmission, the spectrum of infection, and treatment options. There is a need for physicians to be cognizant of emerging pathogens and address their antibiotic resistance profiles.

摘要

戴维斯西地西菌是肠杆菌科的一种革兰氏阴性、无芽孢、具运动性的杆状细菌。它是患有多种合并症的老年患者和免疫功能低下者中的一种机会致病菌。据我们所知,文献中仅报道了12例戴维斯西地西菌血症病例。在此,我们讨论第13例戴维斯西地西菌血症病例,这是首例报告表现为胆汁性败血症的病例。一名41岁女性,因患微小病变病正在服用泼尼松,出现恶心、呕吐、发热和腹泻症状。她有黏膜干燥、巩膜黄疸和肝酶升高。血培养显示为戴维斯西地西菌。经广谱抗生素治疗后病情好转。需要进一步研究以了解其在传播方式、感染谱和治疗选择中的作用。医生有必要认识到新出现的病原体并了解其抗生素耐药情况。

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