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非伤寒沙门氏菌性胃肠炎后出现的沙门氏菌尿路感染和菌血症:一种不寻常的表现。

Salmonella Urinary Tract Infection and Bacteremia Following Non-Typhoidal Salmonella Gastroenteritis: An Unusual Presentation.

作者信息

Altaf Areeba, Tunio Numra, Tunio Sameer, Zafar Meer R, Bajwa Numra

机构信息

Internal Medicine, University at Buffalo/Catholic Health System, Buffalo, USA.

Internal Medicine, Ziauddin University, Karachi, PAK.

出版信息

Cureus. 2020 Dec 20;12(12):e12194. doi: 10.7759/cureus.12194.

Abstract

is primarily known to affect the gastrointestinal tract but can rarely cause infections at uncommon sites, such as the urinary tract. It is known that can infect the urinary tract directly by blood, fecal contamination of urethra, urolithiasis, or secondary intraluminal ascending infection. Our patient is a 59-year-old female with a past medical history of nephrolithiasis and multiple urinary tract infections (UTI) who presented with altered mental status and sepsis complicated by bacteremia and UTI. Urine and blood cultures revealed species > 100,000 colony-forming units per milliliter (CFU/mL) and non-typhoidal , respectively. During the course of her hospital admission, the patient was treated with multiple antibiotics. On further review, it was noted that the patient had presented to the emergency room (ER) about four months earlier with abdominal pain and watery diarrhea with a stool culture being positive for non-typhoidal . Gastroenteritis, sepsis, and enteric fever are normally known with (). Less common extraintestinal diseases like UTI are due to non-typhoidal . The most frequent pathogenesis of UTI is probably hematogenous. UTI caused by non-typhoidal is usually associated with structural abnormalities of the urinary tract. In our case, the patient had non-typhoidal  gastroenteritis followed by non-typhoidal  bacteremia and UTI.

摘要

主要已知会影响胃肠道,但很少会在不常见的部位引起感染,如泌尿道。已知它可通过血液、尿道粪便污染、尿路结石或继发性腔内上行感染直接感染泌尿道。我们的患者是一名59岁女性,有肾结石和多次尿路感染(UTI)病史,出现精神状态改变和败血症,并伴有菌血症和UTI。尿液和血液培养分别显示每毫升有超过100,000菌落形成单位(CFU/mL)的该菌种和非伤寒型该菌。在她住院期间,患者接受了多种抗生素治疗。进一步检查发现,该患者大约四个月前曾因腹痛和水样腹泻到急诊室就诊,粪便培养显示非伤寒型该菌呈阳性。肠胃炎、败血症和肠热通常与该菌()有关。像UTI这样较不常见的肠外疾病是由非伤寒型该菌引起的。非伤寒型该菌引起UTI最常见的发病机制可能是血行性的。由非伤寒型该菌引起的UTI通常与泌尿道结构异常有关。在我们的病例中,患者先是患了非伤寒型肠胃炎,随后出现非伤寒型菌血症和UTI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2365/7815496/d383981379f3/cureus-0012-00000012194-i01.jpg

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