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一名15岁男性通过血浆微生物游离DNA下一代测序检测诊断为克雷伯菌椎间盘炎:病例报告

Klebsiella Discitis in a 15-Year-Old Male Diagnosed With Plasma Microbial Cell-Free DNA Next-Generation Sequencing Test: A Case Report.

作者信息

Karim Farida, Patel Marmik, Barr Lori L, Maurta-Neumann Paola J, Litra Florentina

机构信息

Pediatrics, Sacred Heart Hospital, Pensacola, USA.

Pediatric Radiology, Radiology Associates of Florida-Panhandle Division, Radiology Partners, Pensacola, USA.

出版信息

Cureus. 2022 Jan 14;14(1):e21237. doi: 10.7759/cureus.21237. eCollection 2022 Jan.

Abstract

Spinal discitis (SD) is a rare condition, particularly in the pediatric population. The course of SD may be acute or chronic, and the non-specificity of symptoms leads to great delays in diagnosis. The most commonly isolated causative organism is whereas gram-negative infections are hardly ever reported in the literature. Comorbidities that increase the risk of bacteremia such as diabetes, chronic kidney disease, HIV, and cancer are major risk factors for SD. Hereby, we present an atypical case of SD in a previously healthy 15-year-old male with an unusual organism, , diagnosed by plasma microbial cell-free DNA with negative blood cultures. The clinical course was complicated by antibiotic resistance and subsequent development of a ventral epidural abscess requiring readmission followed by surgical drainage of the abscess with a prolonged course of antibiotics.

摘要

脊柱椎间盘炎(SD)是一种罕见疾病,在儿科人群中尤为少见。SD的病程可能为急性或慢性,症状的非特异性导致诊断出现极大延迟。最常分离出的致病微生物是 ,而革兰氏阴性菌感染在文献中几乎未见报道。增加菌血症风险的合并症,如糖尿病、慢性肾病、艾滋病毒和癌症,是SD的主要危险因素。在此,我们报告一例非典型的SD病例,患者为一名15岁此前健康的男性,感染了一种不常见的微生物 ,通过血浆微生物游离DNA诊断,血培养为阴性。临床病程因抗生素耐药性而复杂化,随后发展为腹侧硬膜外脓肿,需要再次入院,随后对脓肿进行手术引流,并使用延长疗程的抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/187d/8844130/87c6dc1702fe/cureus-0014-00000021237-i01.jpg

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