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人类感染:病例报告及文献综述

Infection in Humans: A Case Report and Review of Literature.

作者信息

Dhital Rashmi, Paudel Anish, Bohra Nidrit, Shin Ann K

机构信息

Reading Hospital and Medical Center, Tower Health System, West Reading, PA, USA.

出版信息

Case Rep Infect Dis. 2020 Feb 19;2020:9545243. doi: 10.1155/2020/9545243. eCollection 2020.

Abstract

. are Gram-negative oxidase-positive nonfermenting rods of Betaproteobacteria class, commonly found in rhizosphere. More recently, some species have transitioned from environment to human hosts, mostly as opportunistic (pathogenic) bacteria. We present a 58-year-old female with non-small-cell lung cancer (NSCLC) who presented with pneumonia and was found to have bacteremia. . A 58-year-old woman with NSCLC on Pralsetinib presented with fevers and rigors for 2 days. Coarse breath sounds were auscultated on the right upper lung field. Labs revealed leukopenia and mild neutropenia. CT chest revealed right upper lobe pneumonia. She was admitted for sepsis secondary to pneumonia and placed on broad spectrum antibiotics with intravenous piperacillin-tazobactam and vancomycin. The patient continued to have fever 2 days after admission (max: 102.8°F). Preliminary blood cultures grew Gram-negative rods. The patient continued to have temperature spikes on the 3rd day of antibiotics ( 101.5°F). Blood cultures revealed oxidase-positive nonfermenting rods. The patient's antibiotic was changed to IV meropenem on the 4th day of hospitalization. Ultimately, on the seventh day of hospitalization, the blood culture was confirmed from outside lab as . The patient started feeling better and defervesced after about 24 hours. . More recently, . have been recovered from humans. Our patient had bacteremia, and reported regularly cleaning her pond and weeding her garden with possible exposure to this environmental proteobacterium. may be more prevalent than earlier thought owing to misidentification. With the institution of appropriate antimicrobial therapy, the outcomes seem mostly favorable.

摘要

. 是β-变形菌纲革兰氏阴性、氧化酶阳性的非发酵杆菌,常见于根际。最近,一些 物种已从环境宿主转变为人类宿主,主要作为机会性(致病)细菌。我们报告一名58岁患有非小细胞肺癌(NSCLC)的女性,她因肺炎就诊并被发现患有 菌血症。. 一名正在服用普拉替尼的NSCLC 58岁女性出现发热和寒战2天。右上肺野听诊有粗湿啰音。实验室检查显示白细胞减少和轻度中性粒细胞减少。胸部CT显示右上叶肺炎。她因肺炎继发败血症入院,并接受了静脉注射哌拉西林-他唑巴坦和万古霉素的广谱抗生素治疗。患者入院2天后仍持续发热(最高体温:102.8°F)。初步血培养生长出革兰氏阴性杆菌。患者在使用抗生素第3天仍有体温波动(最高体温101.5°F))。血培养显示氧化酶阳性的非发酵杆菌。住院第4天患者的抗生素改为静脉注射美罗培南。最终,在住院第7天,外部实验室确认血培养为 。患者开始感觉好转,约24小时后体温下降。. 最近,. 已从人类身上分离出来。我们的患者患有 菌血症,并且报告定期清理池塘和在花园除草,可能接触到这种环境中的变形杆菌。由于错误鉴定, 可能比之前认为的更普遍。通过适当的抗菌治疗,结果似乎大多良好。

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