Miyazaki Manami, Asaka Tomoya, Takemoto Masaaki, Nakano Takaaki
Department of Emergency Medicine, Yokohama Sakae Kyousai Hospital, 132 Katsura Sakae-ku, Yokohama, Kanagawa, 247-8581 Japan.
Department of Emergency Medicine, Shin Yurigaoka General Hospital, 255 Furusawatuko Asou-ku, Kawasaki, Kanagawa, 247-8581 Japan.
IDCases. 2019 Dec 20;19:e00687. doi: 10.1016/j.idcr.2019.e00687. eCollection 2020.
An 83-year-old man visited an orthopedic hospital for his lower back pain. A compression fracture was noted in his second lumbar vertebra. He had taken pain medication for approximately five weeks, but the pain had worsened and he was unable to walk by himself. He was transferred to our hospital and diagnosed with lumbar spondylodiscitis, an iliopsoas abscess, gas gangrene of his left lower limb, and left massive pleural effusion. He was admitted to the intensive care unit. We drained the abscess and pleural effusion, provided continuous hemodiafiltration under ventilator control, and administered intravenous antibiotics. However, he died from sepsis and multiple organ failure three days following admission. Several days after his death, gram-positive cocci were identified in blood culture, pus from the abscess, and pleural exudate; although the causative organism could not be identified. Two weeks subsequent to his death, 16S ribosomal RNA gene sequencing identified in specimens taken from his body.
一名83岁男性因下背部疼痛前往一家骨科医院就诊。其第二腰椎发现有压缩性骨折。他服用止痛药物约五周，但疼痛加剧，已无法自行行走。他被转至我院，被诊断为腰椎椎间盘炎、髂腰肌脓肿、左下肢气性坏疽以及左侧大量胸腔积液。他被收入重症监护病房。我们对脓肿和胸腔积液进行了引流，在呼吸机控制下进行持续血液透析滤过，并静脉注射抗生素。然而，他在入院三天后因败血症和多器官功能衰竭死亡。他死后数天，在血培养、脓肿脓液和胸腔渗出液中发现革兰氏阳性球菌；尽管致病微生物未能明确。他死后两周，16S核糖体RNA基因测序在取自其尸体的标本中鉴定出了（此处原文似乎不完整，未明确鉴定出什么） 。
