感染导致一名免疫功能正常的患者逐渐发展为致命性感染性休克。
infection led to progressively fatal septic shock in an immunocompetent patient.
作者信息
Nakayama Ryuichi, Miyamoto Shuichi, Tawara Toshihiro, Aoyagi Arisa, Oguro Takeo, Kobayashi Nobumichi, Suzuki Michio, Takeyama Yoshihiro
机构信息
Department of Emergency Medicine Hakodate Municipal Hospital Hakodate Japan.
Department of Gastroenterology Hakodate Municipal Hospital Hakodate Japan.
出版信息
Acute Med Surg. 2022 Feb 19;9(1):e738. doi: 10.1002/ams2.738. eCollection 2022 Jan-Dec.
BACKGROUND
infection is rare, with a high fatality rate; however, there are few cases of death with a rapid course. This study reports a progressively fatal case of .
CASE PRESENTATION
A 68-year-old immunocompetent Japanese man was bitten and scratched on his right hand by a dog 6 days before emergency transportation to the emergency room with abdominal pain, back pain, and melena. The patient developed multiple-organ failure. Despite antibiotic therapy, transfusion, vasopressor therapy, and continuous renal replacement therapy, the patient died from uncontrolled metabolic acidosis 4.5 h after admission. Approximately 80 h after admission, blood cultures were positive for .
CONCLUSIONS
infection can lead to rapid progression even in immunocompetent patients.
背景
感染罕见，病死率高；然而，病程迅速的死亡病例很少。本研究报告了一例逐渐致命的……病例。
病例介绍
一名68岁免疫功能正常的日本男性，在因腹痛、背痛和黑便紧急转运至急诊室前6天，右手被狗咬伤和抓伤。患者出现多器官功能衰竭。尽管进行了抗生素治疗、输血、血管升压药治疗和持续肾脏替代治疗，但患者在入院后4.5小时死于无法控制的代谢性酸中毒。入院后约80小时，血培养……呈阳性。
结论
即使在免疫功能正常的患者中，……感染也可导致病情迅速进展。
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