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感染性腹主动脉瘤由弯曲杆菌引起:病例系列和文献系统评价。

Infected aortic aneurysm caused by Helicobacter cinaedi: case series and systematic review of the literature.

机构信息

Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan.

Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan.

出版信息

BMC Infect Dis. 2020 Nov 17;20(1):854. doi: 10.1186/s12879-020-05582-7.

Abstract

BACKGROUND

Helicobacter cinaedi is rarely identified as a cause of infected aneurysms; however, the number of reported cases has been increasing over several decades, especially in Japan. We report three cases of aortic aneurysm infected by H. cinaedi that were successfully treated using meropenem plus surgical stent graft replacement or intravascular stenting. Furthermore, we performed a systematic review of the literature regarding aortic aneurysm infected by H. cinaedi.

CASE PRESENTATION

We present three rare cases of infected aneurysm caused by H. cinaedi in adults. Blood and tissue cultures and 16S rRNA gene sequencing were used for diagnosis. Two patients underwent urgent surgical stent graft replacement, and the other patient underwent intravascular stenting. All three cases were treated successfully with intravenous meropenem for 4 to 6 weeks.

CONCLUSIONS

These cases suggest that although aneurysms infected by H. cinaedi are rare, clinicians should be aware of H. cinaedi as a potential causative pathogen, even in immunocompetent patients. Prolonged incubation periods for blood cultures are necessary for the accurate detection of H. cinaedi.

摘要

背景

希氏弯曲菌很少被认为是感染性动脉瘤的原因;然而,在过去几十年中,报告的病例数量一直在增加,尤其是在日本。我们报告了三例由希氏弯曲菌引起的主动脉瘤感染病例,这些病例均成功地使用美罗培南加手术支架移植物置换或血管内支架治疗。此外,我们对希氏弯曲菌感染性主动脉瘤的文献进行了系统回顾。

病例介绍

我们介绍了三例成人希氏弯曲菌感染性动脉瘤的罕见病例。血液和组织培养物及 16S rRNA 基因测序用于诊断。两名患者接受了紧急手术支架移植物置换,另一名患者接受了血管内支架治疗。所有三例患者均成功接受了 4 至 6 周的静脉用美罗培南治疗。

结论

这些病例表明,尽管由希氏弯曲菌引起的动脉瘤很少见,但临床医生应意识到希氏弯曲菌可能是一种潜在的致病病原体,即使是在免疫功能正常的患者中也是如此。为了准确检测希氏弯曲菌,需要对血液培养物进行长时间的孵育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2012/7670619/64a5b75a8aaf/12879_2020_5582_Fig1_HTML.jpg

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