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胃旁路和胃造口术患者中的侵袭性非伤寒沙门氏菌感染:病例报告。

Invasive nontyphoidal Salmonella infection in a patient with Roux-en-Y gastric bypass and gastrostomy tube: a case report.

机构信息

Medical Scientist Training Program, The Ohio State University College of Medicine, Columbus, USA.

Department of Internal Medicine, Division of Hospital Medicine, The Ohio State University Wexner Medical Center, M112 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH, 43210, USA.

出版信息

J Med Case Rep. 2021 Aug 5;15(1):389. doi: 10.1186/s13256-021-03003-0.

Abstract

BACKGROUND

Infections with nontyphoidal Salmonella most commonly cause a self-limited gastroenteritis in humans and are the leading source of foodborne illness. In the USA, the incidence of culture-confirmed invasive Salmonella is extremely rare. Here, we present a unique case of enteric nontyphoidal Salmonella enteritidis infection that progressed to an invasive bacteremia in a patient with Roux-en-Y gastric bypass and gastrostomy feeding tube.

CASE PRESENTATION

A 58-year-old Caucasian woman with a past medical history of Roux-en-Y gastric bypass with revision and recent gastrostomy feeding tube insertion was admitted with fever and diarrhea. During her inpatient stay, two sets of blood cultures grew Salmonella enteritidis and she was promptly treated with intravenous antibiotics. Her hospital course was also complicated by acute kidney injury. The patient recovered after treatment with a third-generation cephalosporin and supportive treatment.

CONCLUSION

We present an unusual case of nontyphoidal Salmonella enteritidis bacteremia complicated by acute kidney injury in a middle-aged woman with a previous history of Roux-en-Y gastric bypass and gastrostomy feeding tube insertion. Further investigation is needed to identify whether gastric surgeries or procedures are independent risk factors for invasive nontyphoidal salmonellosis.

摘要

背景

非伤寒型沙门氏菌感染在人类中最常引起自限性胃肠炎,是食源性疾病的主要来源。在美国,经培养确认的侵袭性沙门氏菌感染的发病率极为罕见。在此,我们报告了一例独特的肠侵袭性非伤寒型沙门氏菌肠炎感染病例,该病例发生在一位接受 Roux-en-Y 胃旁路和胃造口管喂养的患者中,并进展为侵袭性菌血症。

病例介绍

一位 58 岁白人女性,既往有 Roux-en-Y 胃旁路手术和近期胃造口管插入的病史,因发热和腹泻入院。在住院期间,两次血培养均培养出肠炎沙门氏菌,随后立即给予静脉抗生素治疗。她的住院过程还并发了急性肾损伤。在接受第三代头孢菌素治疗和支持治疗后,患者痊愈。

结论

我们报告了一例中年女性非伤寒型肠炎沙门氏菌菌血症合并急性肾损伤的不常见病例,该患者既往有 Roux-en-Y 胃旁路和胃造口管插入的病史。需要进一步研究以确定胃手术或操作是否是非伤寒型沙门氏菌感染的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbeb/8340372/3c27b1b07178/13256_2021_3003_Fig1_HTML.jpg

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