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一名肾移植受者发生胎儿弯曲菌血症,并发多发性脾脓肿和多脏器体征:病例报告及文献复习

Campylobacter fetus bacteremia complicated by multiple splenic abscesses and multivisceral signs in a renal transplant recipient: a case report and review of the literature.

作者信息

Coustillères François, Hanoy Mélanie, Lemée Ludovic, Le Roy Frank, Bertrand Dominique

机构信息

Department of Nephrology, Rouen University Hospital, Bois-Guillaume, France.

Department of Nephrology, Rouen University Hospital, Bois-Guillaume, France.

出版信息

Braz J Infect Dis. 2022 Mar-Apr;26(2):102336. doi: 10.1016/j.bjid.2022.102336. Epub 2022 Feb 25.

Abstract

We report a rare case of Campylobacter fetus bacteremia in a 50-year-old woman following kidney transplantation. Bacteremia was complicated by multivisceral signs such as multiple splenic abscesses, bacterial hepatitis, erythema nodosum and reactive arthritis. Despite a prolonged diagnostic delay, the diagnosis was made on blood culture identification and the global outcome was favorable with adequate antibiotherapy. Reports in the literature describe a high rate of mortality for Campylobacter spp. septicemia, with most patients being immunocompromised. However, Campylobacter spp. has been rarely described in renal transplant patients. Moreover, a splenic septic localization due to Campylobacter spp. has been reported only once to our knowledge. Clinicians should be aware of the diagnostic difficulties related to the frequent negativity of stool samples in C. fetus septicemia, in order to implement a tailored medical strategy. Some data suggest that rapid introduction of adapted antibiotic therapy is associated with a reduction in mortality.

摘要

我们报告了一例罕见的肾移植术后50岁女性空肠弯曲菌血症病例。菌血症并发多脏器症状,如多发脾脓肿、细菌性肝炎、结节性红斑和反应性关节炎。尽管诊断延迟较长,但通过血培养鉴定得以确诊,经适当的抗生素治疗后总体预后良好。文献报道空肠弯曲菌败血症死亡率很高,大多数患者存在免疫功能低下。然而,肾移植患者中空肠弯曲菌属感染鲜有报道。此外,据我们所知,空肠弯曲菌属引起的脾脏感染性定位仅报道过一次。临床医生应意识到胎儿弯曲菌败血症粪便样本频繁阴性所带来的诊断困难,以便实施针对性的治疗策略。一些数据表明,迅速采用合适的抗生素治疗与死亡率降低有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a11/9387491/c261d515fbe8/gr1.jpg

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