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一份关于健康年轻个体获得性鸟氨酸罗伊氏菌感染的病例报告。

A case report of community-acquired Raoultella ornithinolytica infection in a healthy, young individual.

机构信息

Emergency and Acute Critical Care Department, Huashan Hospital North, Fudan University, Shanghai, China.

出版信息

BMC Infect Dis. 2021 Oct 24;21(1):1095. doi: 10.1186/s12879-021-06799-w.

Abstract

BACKGROUND

Raoultella ornithinolytica is a Gram-negative bacillus that resembles Klebsiella. This bacterium is present in many soil and aquatic environments and is a major causative agent of healthcare-associated infections (HAIs) in medical staff. Clinically, it has been reported to contribute to nosocomial infections in patients that include but are not limited to gastrointestinal, skin, and genitourinary tract infections. These complications are most common in hospitalized patients with underlying immunodeficiency, multiple comorbidities, or those receiving invasive surgery.

CASE PRESENTATION

We present a case of a 25-year-old patient with a R. ornithinolytica infection. The patient had no history of any disease. Her main complaints were high fever, a scattered maculopapular rash, and superficial lymph node enlargement (SLNE). Peripheral blood samples were collected for high-throughput sequencing analysis to identify pathogenic microorganisms. The results confirmed a R. ornithinolytica infection, which was treated successfully using meropenem. Loratadine was also administered to treat the patient's compromised skin condition caused by an allergic reaction.

CONCLUSIONS

To our knowledge, this is the first case of a systemic maculopapular rash and superficial lymphadenopathy caused by a R. ornithinolytica infection acquired at the community level. Based on this case, we recommend a combination of antibiotic and antiallergic drugs to treat a R. ornithinolytica infection and associated allergic reaction to the bacteria.

摘要

背景

ornithinolytica 是一种类似于克雷伯氏菌的革兰氏阴性杆菌。这种细菌存在于许多土壤和水生环境中,是医务人员相关医院感染(HAI)的主要病原体。临床上,它已被报道可导致包括但不限于胃肠道、皮肤和泌尿生殖道感染在内的医院感染。这些并发症最常见于患有潜在免疫缺陷、多种合并症或接受侵入性手术的住院患者。

病例介绍

我们报告了一例 25 岁 ornithinolytica 感染患者。该患者无任何疾病史。她的主要症状是高热、散在的斑丘疹和浅表淋巴结肿大(SLNE)。采集外周血样本来进行高通量测序分析以鉴定致病微生物。结果证实了 ornithinolytica 感染,使用美罗培南成功治疗。还给予氯雷他定治疗患者因过敏反应而受损的皮肤状况。

结论

据我们所知,这是首例社区获得性 ornithinolytica 感染引起的全身性斑丘疹和浅表淋巴结病的病例。基于该病例,我们建议联合使用抗生素和抗过敏药物来治疗 ornithinolytica 感染及其对细菌的过敏反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6283/8543906/955a4044e2a7/12879_2021_6799_Fig1_HTML.jpg

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