Dietrich Tyson, Garcia Katelynn, Strain Joe, Ashurst John
Kingman Regional Medical Center, Department of Pharmacy, 3269 Stockton Hill Road, Kingman, AZ 86409, USA.
Regional Health Rapid City Hospital, Department of Pharmacy, 353 Fairmont Blvd, Rapid City, SD 57701, USA.
Case Rep Infect Dis. 2019 Sep 26;2019:9870510. doi: 10.1155/2019/9870510. eCollection 2019.
is a Gram-negative coccobacillus that is rarely encountered in clinical practice. Patients can present with cutaneous, pulmonary, cardiac, mucous membrane, or gastrointestinal involvement. A clinician should have a heightened suspicion in endemic areas or when outbreaks appear. Diagnosis is achieved through serological testing or polymerase chain reaction assays. Although historically the treatment of choice was streptomycin, gentamicin is now preferred due to its availability and relatively safer side effect profile with extended-interval dosing. Limited published evidence exists on the effectiveness of extended-interval gentamicin for tularemia. This case series describes four patients with pulmonic tularemia successfully treated with extended-interval dosing of gentamicin without treatment failure or relapse.
是一种革兰氏阴性球杆菌,在临床实践中很少遇到。患者可能出现皮肤、肺部、心脏、黏膜或胃肠道受累。临床医生在流行地区或出现疫情时应提高警惕。通过血清学检测或聚合酶链反应测定进行诊断。虽然历史上首选的治疗药物是链霉素,但由于庆大霉素容易获得且延长给药间隔时副作用相对更安全,现在更受青睐。关于延长给药间隔的庆大霉素治疗兔热病的有效性,现有公开证据有限。本病例系列描述了4例肺兔热病患者成功接受延长给药间隔的庆大霉素治疗,未出现治疗失败或复发。