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[奥斯陆莫拉菌败血症合并肺炎:以色列首例报告病例]

[MORAXELLA OSLOENSIS BACTEREMIA WITH PNEUMONIA: FIRST REPORTED CASE IN ISRAEL].

作者信息

Bilyk Valeriy, Ali Othman, Moghrabi Ahmad

机构信息

Galilee Medical Center, Department of Internal Medicine "D", Nahariya.

出版信息

Harefuah. 2020 Mar;159(3):163-165.

Abstract

Community acquired pneumonia (CAP), an acute infection of the pulmonary parenchyma acquired in the community, is generally treated in an outpatient setting and involves different etiological agents. In the adult community, the most common pathogen in the disease is Streptococcus pneumonia, though other multiple etiological agents (atypical) have been involved, including Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. The genus Moraxella consists of aerobic, oxidase-positive gram-negative coccobacilli. Moraxella catarrhalis is known to be a common inhabitant of the upper respiratory tract and has been implicated as an etiologic agent in multiple diseases of the respiratory tract (but not limited to), such as bronchitis, pneumonia, otitis media, and sinusitis. The species Moraxella osloensis is a gram-negative opportunistic human pathogen, which has been found to cause several human diseases and infections such as meningitis, vaginitis, sinusitis, bacteremia, endocarditis, and septic arthritis. However, due to the subject's rarity, there is a paucity of information in the medical literature regarding its clinical significance, epidemiological data and appropriate therapy. We present the first case reported in Israel of Moraxella osloensis bacteremia in a patient with multiple co-morbidities including C. difficile infection (CDI) carrier state which presented with clinical symptoms (supported by radiological features) of community-acquired pneumonia. The patient was initially treated with empiric antibiotics including a 3rd generation cephalosporin and a macrolide that were substituted with IV Augmentin (Amoxicillin-Clavulanic acid) according to the organism's sensitivity tests. Our patient showed remarkable clinical and laboratory improvement with the therapy mentioned above.

摘要

社区获得性肺炎(CAP)是在社区获得的肺实质急性感染,通常在门诊治疗,涉及不同的病原体。在成人社区中,该疾病最常见的病原体是肺炎链球菌,不过也涉及其他多种病原体(非典型病原体),包括肺炎支原体、肺炎衣原体和嗜肺军团菌。莫拉克斯氏菌属由需氧、氧化酶阳性的革兰氏阴性球杆菌组成。卡他莫拉菌是上呼吸道的常见定植菌,已被认为是多种呼吸道疾病(但不限于)的病原体,如支气管炎、肺炎、中耳炎和鼻窦炎。奥斯陆莫拉克斯氏菌是一种革兰氏阴性机会致病菌,已发现可导致多种人类疾病和感染,如脑膜炎、阴道炎、鼻窦炎、菌血症、心内膜炎和化脓性关节炎。然而,由于该病原体较为罕见,医学文献中关于其临床意义、流行病学数据和适当治疗的信息较少。我们报告了以色列首例奥斯陆莫拉克斯氏菌血症病例,患者患有多种合并症,包括艰难梭菌感染(CDI)携带者状态,表现出社区获得性肺炎的临床症状(有影像学特征支持)。患者最初接受经验性抗生素治疗,包括第三代头孢菌素和大环内酯类抗生素,根据病原体敏感性试验,后改用静脉注射奥格门汀(阿莫西林 - 克拉维酸)。通过上述治疗,我们的患者在临床和实验室检查方面均有显著改善。

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