Xiao Jianchun, Zhang Ruopeng, Chen Wanqi, Niu Beizhan
Department of General Surgery, Peking Union Medical College Hospital, Beijing, China.
J Int Med Res. 2020 Nov;48(11):300060520967820. doi: 10.1177/0300060520967820.
A 63-year-old woman was admitted to our hospital with herpes zoster viral infection and intermittent disorder of consciousness. On day 13 of hospitalization for glucocorticoid treatment, the patient experienced seven episodes of hematochezia. She had a 2-year history of systemic lupus erythematosus and had undergone splenectomy at 40 years of age. Computed tomography and electronic endoscopy revealed bleeding and contrast agent leakage into the splenic flexure of the colon. The patient underwent an emergency exploratory laparotomy and left hemicolectomy for suspected active hemorrhaging into the digestive tract. Pathological examination revealed that the bleeding had been caused by a fungal infection. No further hemorrhaging occurred after the surgery, suggesting that intestinal fungal infection might be a potential differential diagnosis for gastrointestinal bleeding in compromised hosts.
一名63岁女性因带状疱疹病毒感染和意识间歇性障碍入住我院。在住院第13天接受糖皮质激素治疗时,患者出现了7次便血。她有2年的系统性红斑狼疮病史,40岁时接受了脾切除术。计算机断层扫描和电子内窥镜检查显示结肠脾曲有出血和造影剂渗漏。患者因怀疑消化道有活动性出血接受了急诊剖腹探查术和左半结肠切除术。病理检查显示出血是由真菌感染引起的。术后未再发生出血,提示肠道真菌感染可能是免疫功能低下宿主胃肠道出血的一个潜在鉴别诊断。