胎儿弯曲菌菌血症和脑膜炎合并急性淋巴细胞白血病患者维持治疗期间感染：病例报告
Campylobacter fetus bacteremia and meningitis in an acute lymphoblastic leukemia patient undergoing maintenance therapy: a case report.
机构信息
Department of Internal Medicine, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan.
Department of Hematology, St. Luke's International Hospital, Tokyo, Japan.
出版信息
BMC Infect Dis. 2021 Jul 13;21(1):680. doi: 10.1186/s12879-021-06364-5.
BACKGROUND
Campylobacter fetus is an uncommon Campylobacter species, and its infections mainly cause infective endocarditis, aortic aneurysm, and meningitis rather than enteritis. It is more likely to be detected in blood than Campylobacter jejuni or Campylobacter coli, specifically reported in 53% of patients. In our case, C. fetus was detected in both blood and cerebrospinal fluid (CSF) cultures.
CASE PRESENTATION
A 33-year-old woman, who was on maintenance chemotherapy for acute lymphoblastic leukemia (ALL), presented to our clinic with chief complaints of severe headache and nausea. Blood and CSF cultures revealed C. fetus. We administrated meropenem 2 g intravenously (IV) every 8 h for 3 weeks, and she was discharged without neurological sequelae.
CONCLUSION
We encountered a case of C. fetus meningitis without gastrointestinal symptoms, neck stiffness or jolt accentuation in a patient with ALL. Undercooked beef was considered the source of C. fetus infection in this case, suggesting that the need for a neutropenic diet and safe food handling be considered.
背景
胎儿弯曲菌是一种不常见的弯曲菌属，其感染主要引起感染性心内膜炎、主动脉瘤和脑膜炎，而不是肠炎。与空肠弯曲菌或大肠弯曲菌相比，它更有可能在血液中被检测到，具体在 53%的患者中被报告。在我们的病例中，胎儿弯曲菌在血液和脑脊液（CSF）培养物中均被检测到。
病例介绍
一名 33 岁女性，因急性淋巴细胞白血病（ALL）维持化疗而就诊，主要抱怨严重头痛和恶心。血液和 CSF 培养显示胎儿弯曲菌。我们给予美罗培南 2 g 静脉滴注（IV），每 8 小时一次，共 3 周，患者出院时无神经后遗症。
结论
我们遇到了一例 ALL 患者无胃肠道症状、颈部僵硬或顿挫加重的胎儿弯曲菌脑膜炎。本例中，未煮熟的牛肉被认为是胎儿弯曲菌感染的来源，这表明需要考虑中性粒细胞减少症饮食和安全的食物处理。
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