Ishihara Toru, Yanagi Hidetaka, Oki Masayuki, Ozawa Hideki
Division of General Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
IDCases. 2021 Apr 30;24:e01134. doi: 10.1016/j.idcr.2021.e01134. eCollection 2021.
infection is known to cause Lemierre's syndrome, not pelvic peritonitis. Herein, we report a case of pelvic peritonitis and bacteremia, without Lemierre's syndrome, mimicking intestinal necrosis. A 28-year-old woman with peritoneal irritation and shock was suspected of having intestinal necrosis due to the presence of hepatoportal venous gas and pneumatosis intestinalis. Intestinal necrosis was ruled out by emergency laparotomy. However, massive opaque ascites and inflammatory changes in the uterus and fallopian tubes were observed. and were found in ascetic fluid cultures. Moreover, was also found in blood culture. Systemic management of septic shock and antibiotic treatment improved the patient's general condition and abnormal gas on imaging. The patient had untreated bacterial vaginosis prior to admission. Pelvic peritonitis caused by is extremely rare. However, it must be recognized to avoid its rapid development into severe onset mimicking intestinal necrosis.
已知感染会导致 Lemierre 综合征，而非盆腔腹膜炎。在此，我们报告一例盆腔腹膜炎和菌血症病例，该病例无 Lemierre 综合征，却酷似肠坏死。一名 28 岁出现腹膜刺激征和休克的女性，因肝门静脉积气和肠壁积气而被怀疑患有肠坏死。急诊剖腹探查排除了肠坏死。然而，观察到大量不透明腹水以及子宫和输卵管的炎症改变。腹水培养中发现了[具体细菌名称 1]和[具体细菌名称 2]。此外，血培养中也发现了[具体细菌名称 1]。感染性休克的全身治疗和抗生素治疗改善了患者的一般状况以及影像学上的异常气体表现。患者入院前患有未治疗的细菌性阴道病。由[具体细菌名称 1]引起的盆腔腹膜炎极为罕见。然而，必须认识到这一点，以避免其迅速发展为酷似肠坏死的严重病症。
