Anezaki Hiroki, Terada Norohiko, Kawamura Takahisa, Kurai Hanako
Division of Infectious Diseases, Shizuoka Cancer Center Hospital, Suntou-gun, Shizuoka, Japan.
Department of Internal Medicine, Shizuoka Prefectural Hospital Organization, Shizuoka City, Shizuoka, Japan.
IDCases. 2020 Feb 5;19:e00712. doi: 10.1016/j.idcr.2020.e00712. eCollection 2020.
An 81-year-old man with lung cancer with bone metastases, interstitial pneumonia, and emphysema, was hospitalized for pain control. He developed fever and chills during hospitalization. Physical examination revealed a fever of 39.1 °C, but there were no findings on history or physical examination to suggest the source of the infection. Gram-negative cocci were detected in the blood culture (Fig. 1) and in a Gram stained sputum smear (Figs. 3 and 4). and were ruled out based on history and an absence of suggestive symptoms. The cause of his fever was diagnosed as bacteremic pneumonia based on the blood culture and the sputum smear results, and he was treated with intravenous ceftriaxone. This case illustrates the importance of Gram staining of sputum and blood culture. should be considered in the differential diagnosis when gram-negative cocci are detected in the blood and the sputum.
一名81岁男性，患有肺癌伴骨转移、间质性肺炎和肺气肿，因疼痛控制入院。他在住院期间出现发热和寒战。体格检查发现体温为39.1°C，但病史和体格检查均未发现提示感染源的迹象。血培养（图1）和革兰氏染色痰涂片（图3和图4）中检测到革兰氏阴性球菌。根据病史和无提示性症状排除了[具体疾病1]和[具体疾病2]。根据血培养和痰涂片结果，他发热的原因被诊断为[具体细菌名称]菌血症性肺炎，并用静脉注射头孢曲松进行治疗。该病例说明了痰涂片革兰氏染色和血培养的重要性。当在血液和痰中检测到革兰氏阴性球菌时，在鉴别诊断中应考虑[具体疾病]。
