Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines.
BMJ Case Rep. 2020 Sep 7;13(9):e235926. doi: 10.1136/bcr-2020-235926.
Hypervirulent strains of are known to cause liver abscesses and other metastatic infections. Being Asian and having diabetes are known host risk factors. Here we present an unusual case of a Filipino ballet dancer-choreographer with diabetes presenting with bilateral leg pains initially thought to be cellulitis, but was eventually diagnosed as bilateral subcutaneous leg abscesses. He also had a liver abscess, thankfully asymptomatic, which was only discovered on imaging. The occurrence of three distant abscesses in one patient, hence '3-in-1,' makes this case worth reporting. Bilateral subcutaneous leg abscesses as the presenting manifestation of this infection have not been reported yet. We hypothesise that his occupation which makes use of frequent contractions of leg muscles led to increased blood flow and preferentially directed blood-borne bacteria to localise in both legs. We have also characterised the pathogen with regards to its hypermucoviscous phenotype, capsular type, virulence genes and phylogeny.
已知 具有强毒力的菌株可导致肝脓肿和其他转移性感染。已知的宿主危险因素包括亚洲人身份和糖尿病。这里我们报告了一个不寻常的病例，一名患有糖尿病的菲律宾芭蕾舞演员兼编舞者最初出现双侧腿部疼痛，最初被认为是蜂窝织炎，但最终被诊断为双侧皮下腿部脓肿。他还患有肝脓肿，幸运的是无症状，仅在影像学检查中发现。一名患者出现三个远处脓肿，因此称为“三合一”，这使得该病例值得报告。这种感染以双侧皮下腿部脓肿为表现的情况尚未见报道。我们推测，他的职业需要频繁地收缩腿部肌肉，这导致血流增加，并使血流中的细菌优先定植于双腿。我们还对病原体的高黏液表型、荚膜类型、毒力基因和系统发育进行了特征描述。
