左氧氟沙星和头孢吡肟联合治疗河水溺水事故后严重呼吸道感染。
Combination therapy with levofloxacin and cefepime to treat severe respiratory infection due to after a near-drowning accident in river water.
作者信息
Maeda Atsuo, Nakajima Yasuhiro, Yanagisawa Kaoru, Sugimoto Tatsuya, Harano Kohei, Kaki Yuki, Sasaki Jun, Dohi Kenji, Hayashi Munetaka
机构信息
Department of Emergency and Disaster Medicine Showa University Tokyo Japan.
出版信息
Acute Med Surg. 2021 Nov 3;8(1):e708. doi: 10.1002/ams2.708. eCollection 2021 Jan-Dec.
BACKGROUND
spp. are gram-negative anaerobic rods that are mainly found in water. Respiratory infections due to sp. are rare but have a high mortality rate.
CASE PRESENTATION
A 43-year-old man fell into a river following an automobile accident and almost drowned. He developed a severe respiratory infection and acute respiratory distress syndrome. Ampicillin/sulbactam was given; however, was detected in his blood culture. Despite treatment with levofloxacin, to which was susceptible, his condition failed to improve. However, with additional treatment with cefepime, his blood culture results were negative, and his condition improved.
CONCLUSION
When a patient develops a respiratory infection after aspiration of river water, empiric antimicrobial therapy should be given as soon as possible to manage the risk of sp. infection.
背景
[具体菌种名称]是革兰氏阴性厌氧杆菌，主要存在于水中。由[具体菌种名称]引起的呼吸道感染罕见，但死亡率高。
病例报告
一名43岁男子在车祸后坠入河中，险些溺水。他患上了严重的呼吸道感染和急性呼吸窘迫综合征。给予氨苄西林/舒巴坦治疗；然而，在他的血培养中检测到了[具体菌种名称]。尽管使用了左氧氟沙星进行治疗，[具体菌种名称]对其敏感，但他的病情并未改善。然而，加用头孢吡肟治疗后，他的血培养结果转为阴性，病情有所改善。
结论
当患者在吸入河水后发生呼吸道感染时，应尽快给予经验性抗菌治疗，以应对[具体菌种名称]感染的风险。
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