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产泛耐药性金黄色葡萄球菌素的肾脓肿:一个不常见病例报告及文献复习。

Renal abscess caused by Panton-Valentine leukocidin-producing : report of an unusual case and review of the literature.

机构信息

Unité Mobile de Microbiologie Clinique, Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

出版信息

Infect Dis (Lond). 2021 Feb;53(2):131-136. doi: 10.1080/23744235.2020.1856920. Epub 2020 Dec 14.

Abstract

BACKGROUND

Renal abscesses are rare and mainly caused by an ascending infection due to Gram-negative microorganisms. We report the first case of a renal abscess caused by Panton-Valentine leukocidin-producing in an immunocompetent patient, and we present a comprehensive review of the literature.

CASE PRESENTATION

A 20-year-old immunocompetent woman had a 2-month history of left-sided back pain, fever and urinary symptoms. Urinalysis showed leukocyturia (19,000/mm) without bacteriuria. Intravenous cefotaxime treatment was initiated. A computed tomographic scan showed a large abscess in the left kidney. Computed tomographic percutaneous drainage was done and cultures of abscess and blood grew methicillin-susceptible Panton-Valentine leukocidin-producing . Treatment was switched to cefazoline and then to clindamycin for 21 days. The patient quickly improved and the abscess was completely resolved 6 months after end of antibiotic treatment.

CONCLUSION

To our knowledge, this is the first report of a renal abscess caused by Panton-Valentine leukocidin-producing Treatment with percutaneous drainage and an antibiotic with toxin inhibiting effect was successful.

摘要

背景

肾脓肿罕见,主要由革兰氏阴性微生物上行感染引起。我们报告首例免疫功能正常患者由产 Panton-Valentine 白细胞毒素的 引起的肾脓肿,并对文献进行了全面回顾。

病例介绍

一名 20 岁免疫功能正常的女性有 2 个月的左侧背痛、发热和尿路症状史。尿分析显示白细胞尿(19000/mm),无菌尿。给予静脉头孢噻肟治疗。计算机断层扫描显示左肾有一个大脓肿。行计算机断层扫描经皮引流,脓肿和血培养出耐甲氧西林的产 Panton-Valentine 白细胞毒素的 。治疗改为头孢唑啉,然后用克林霉素治疗 21 天。患者迅速好转,抗生素治疗结束后 6 个月脓肿完全消退。

结论

据我们所知,这是首例由产 Panton-Valentine 白细胞毒素的 引起的肾脓肿报告。经皮引流和具有毒素抑制作用的抗生素治疗成功。

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