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化疗方案下成年患者的导管相关脓毒症

Catheter-Related Sepsis by in an Adult Patient under Chemotherapy Regimen.

作者信息

Piatti Gabriella, Feltrin Sara, Fellini Emanuela, Barbero Valentina, Ballestrero Alberto

机构信息

Ospedale Policlinico San Martino, 10 Largo Benzi, Genoa 16132, Italy.

Department of Surgical and Diagnostic Sciences (DISC), Section of Microbiology, University of Genoa, 8 Largo Benzi, Genoa 16132, Italy.

出版信息

Case Rep Infect Dis. 2021 Mar 5;2021:8858157. doi: 10.1155/2021/8858157. eCollection 2021.

Abstract

is present in animals and humans in different organs and biological liquids, usually as a saprophyte. We report the case of a 61-year-old woman diagnosed with stage IV metastatic lobular breast cancer, carrying a central venous catheter (port-a-cath) and bilateral stents for perirenal infiltration by malignancy. During chemotherapy regimen, a febrile episode occurred, along with a high level of serum glucan. The port-a-cath was removed after blood collection for culture, which gave isolation of strains. Given high glucan level and the patient's frailty, empirical treatment with fluconazole was started with load-dose, 800 mg orally, at day 1 and, afterwards, with 400 mg daily for two weeks. The phenotype of susceptibility to antibiotics of the strain demonstrated lower minimal inhibitory concentration to fluconazole than that reported in the literature. The patient remained asymptomatic, and inflammation parameters showed normalization. Unfortunately, three weeks later, meningeal localization of cancer caused rapid deterioration and death.

摘要

通常作为腐生菌存在于动物和人类的不同器官及生物体液中。我们报告了一例61岁女性患者,诊断为IV期转移性小叶乳腺癌,携带中心静脉导管(输液港),因恶性肿瘤肾周浸润置入双侧支架。在化疗期间,出现发热,同时血清葡聚糖水平升高。采集血样进行培养后取出输液港,培养分离出菌株。鉴于葡聚糖水平高且患者身体虚弱,开始经验性使用氟康唑治疗,第1天口服负荷剂量800mg,之后每日400mg,持续两周。该菌株对抗生素的药敏表型显示,其对氟康唑的最低抑菌浓度低于文献报道。患者无症状,炎症指标恢复正常。不幸的是,三周后,癌症脑膜转移导致病情迅速恶化并死亡。

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