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假丝酵母菌和嗜麦芽寡养单胞菌引起神经外科手术后医院获得性脑膜炎:一种罕见的合并感染。

Candida utilis and Stenotrophomonas maltophilia causing nosocomial meningitis following a neurosurgical procedure: A rare co-infection.

机构信息

Pharmacy Care Division, Clinical Pharmacy Section, King Saud Medical City, Riyadh, Saudi Arabia.

Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.

出版信息

J Infect Public Health. 2021 Nov;14(11):1715-1719. doi: 10.1016/j.jiph.2021.10.004. Epub 2021 Oct 13.

Abstract

Candida utilis and Stenotrophomonas maltophilia co-infections connected to meningitis are uncommon. We describe a patient who developed C. utilis and S. maltophilia after undergoing neurosurgery and received effective nosocomial meningitis treatment. Multiple neurosurgeries were required for a 16-year-old girl due to complications. For probable nosocomial meningitis, she was treated with cefepime with vancomycin. Meropenem and liposomal amphotericin B were prescribed after her seizure and positive CSF culture for Candida utilis. Consequently, S. maltophilia was discovered in the CSF, and ceftazidime and trimethoprim-sulfamethoxazole were prescribed. The patient has been hemodynamically stable for the past two months, and consecutive CSF cultures have been negative. To the best of our knowledge, this is the first case of C. utilis and S. maltophilia co-infection that has been successfully handled.

摘要

黏质沙雷氏菌和鲁氏不动杆菌合并感染相关性脑膜炎并不常见。我们描述了一位患者,在接受神经外科手术后发生黏质沙雷氏菌和鲁氏不动杆菌合并感染相关性脑膜炎,并接受了有效的院内感染性脑膜炎治疗。一位 16 岁女孩因并发症需要多次神经外科手术。为了治疗可能的院内感染性脑膜炎,她接受了头孢吡肟联合万古霉素治疗。在她出现癫痫和脑脊液培养出假丝酵母菌属后,给予美罗培南和两性霉素 B 脂质体。随后,在脑脊液中发现了黏质沙雷氏菌,因此给予头孢他啶和复方磺胺甲噁唑治疗。在过去的两个月中,患者血流动力学一直稳定,连续的脑脊液培养均为阴性。据我们所知,这是首例黏质沙雷氏菌和鲁氏不动杆菌合并感染并成功处理的病例。

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