子宫内膜炎相关的腺肌病引起的侵袭性非定型流感嗜血杆菌感染。
Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis.
机构信息
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, Japan.
出版信息
BMC Infect Dis. 2020 Jul 16;20(1):521. doi: 10.1186/s12879-020-05193-2.
BACKGROUND
The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare.
CASE PRESENTATION
A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis.
CONCLUSIONS
Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.
背景
流感嗜血杆菌 b 型疫苗的广泛应用导致了无荚膜流感嗜血杆菌（NTHi）的流行。然而，基于妇科疾病的侵袭性 NTHi 感染仍较为少见。
病例介绍
一名 51 岁日本女性，患有腺肌瘤，出现发热。血培养和阴道分泌物培养均为 NTHi 阳性。镓闪烁扫描显示子宫摄取度高，诊断为侵袭性 NTHi 感染。除了抗生素治疗外，还进行了全子宫切除术。病理分析发现腺肌瘤中有微脓肿形成。
结论
尽管腺肌瘤微脓肿引起的 NTHi 菌血症较为少见，但该病例强调了在患有妇科疾病的患者中，包括无已知原发性病灶的侵袭性 NTHi 感染，需要将子宫视为感染的潜在来源。
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