罕见的巨大芽孢杆菌软组织感染病例。
A rare case of Bacillus megaterium soft tissues infection.
机构信息
Array.
Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome.
出版信息
Acta Biomed. 2020 Dec 30;91(14-S):e2020013. doi: 10.23750/abm.v91i14-S.10849.
BACKGROUND AND AIM OF THE WORK
To report the history and clinical presentation of a 60-year-old male who developed a rare soft tissue infection of the right leg caused by Bacillus megaterium and to perform a Literature review focusing on clinical manifestations and diagnostic difficulties of the aforementioned bacterium.
METHODS
Medical history and clinical presentation suggested the infectious etiology, which led to the surgical procedure of fistulectomy and to further histological and microbiological investigations with bacterial cultures.
RESULTS
The histological report tested negative for osteomyelitis. Bacterial cultures revealed Bacillus megaterium, which was sensitive to all antibiotics against which it was tested. The oral antibiotic therapy was set for 12 days with benefits. The patient has always been apyretic, inflammation indexes and white cells count have been within normal limits. Conclusions: This was a rare case of soft tissue infection caused by Bacillus megaterium known to be a "non-pathogenic" bacterium. The infection was likely acquired by the penetration through the injury wound. The combination of surgical and antibiotic therapy lead to complete skin healing and infection resolution at the 6-months follow up.
背景与工作目的
报告一例罕见的右下肢软组织感染病例，患者为 60 岁男性，由巨大芽孢杆菌引起。本文旨在对该细菌的临床表现和诊断难点进行文献复习。
方法
根据病史和临床表现，怀疑为感染性病因，进而进行瘘管切除术，并进行进一步的组织学和微生物学检查，包括细菌培养。
结果
组织学报告排除骨髓炎。细菌培养显示为巨大芽孢杆菌，该菌对所有测试的抗生素均敏感。口服抗生素治疗 12 天，效果良好。患者一直无发热，炎症指标和白细胞计数均在正常范围内。
结论
这是一例罕见的由巨大芽孢杆菌引起的软组织感染病例，该菌通常被认为是“非致病性”细菌。感染可能是通过伤口穿透而获得的。手术和抗生素治疗的联合应用导致皮肤完全愈合，感染在 6 个月随访时得到解决。
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