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中国一名患有坏死性小肠结肠炎的新生儿因败血症导致严重血管内溶血:病例报告

Severe Intravascular Hemolysis from Septicemia in a Neonate with Necrotizing Enterocolitis in China: A Case Report.

作者信息

Li Zhiqi, Yan Chongbing, Gong Xiaohui, Wang Junfang

机构信息

Department of Neonatology, ChangNing Maternity and Infant Health Institute, Shanghai, 200051, People's Republic of China.

Department of Neonatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, People's Republic of China.

出版信息

Infect Drug Resist. 2022 Apr 2;15:1461-1465. doi: 10.2147/IDR.S355621. eCollection 2022.

Abstract

is a gram-positive anaerobic bacillus. As an opportunistic pathogen, can colonize the intestine of infants, but highly pathogenic forms are uncommon in newborns. Sporadic cases of neonatal infection have been reported worldwide, but no case has yet been reported in Chinese neonates. We herein report the first Chinese neonate who developed severe intravascular hemolysis and necrotizing enterocolitis following septicemia. A 7-day-old full-term female newborn was admitted to our hospital with necrotizing enterocolitis. The patient developed severe intravascular hemolysis on the day of admission and underwent continuous renal replacement therapy for hyperkalemia and severe acute kidney injury. Despite optimal treatment, this baby died at 20 hours after admission. Clinical metagenomic next-generation sequencing for pathogen detection showed a positive result for . Literature on -associated sepsis in neonates was reviewed to offer a reference for clinical practice. Our case demonstrates that neonatologists should consider a diagnosis of infection in a newborn when symptoms of severe intestinal infection and intravascular hemolysis are present, so that early treatment can be initiated.

摘要

是一种革兰氏阳性厌氧芽孢杆菌。作为一种机会致病菌,可在婴儿肠道定植,但高致病性形式在新生儿中并不常见。全球已报道新生儿感染的散发病例,但中国新生儿中尚未有病例报道。我们在此报告首例患败血症后发生严重血管内溶血和坏死性小肠结肠炎的中国新生儿。一名7日龄足月儿女婴因坏死性小肠结肠炎入住我院。患儿入院当天发生严重血管内溶血,并因高钾血症和严重急性肾损伤接受持续肾脏替代治疗。尽管进行了最佳治疗,该婴儿仍在入院后20小时死亡。用于病原体检测的临床宏基因组下一代测序显示 呈阳性结果。回顾了关于新生儿 相关败血症的文献,为临床实践提供参考。我们的病例表明,当新生儿出现严重肠道感染和血管内溶血症状时,新生儿科医生应考虑 感染的诊断,以便尽早开始治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b49/8986761/c638d77fed29/IDR-15-1461-g0001.jpg

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本文引用的文献

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Next-generation sequencing diagnostics of bacteremia in pediatric sepsis.儿童脓毒症中菌血症的下一代测序诊断
Medicine (Baltimore). 2021 Jun 25;100(25):e26403. doi: 10.1097/MD.0000000000026403.
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Necrotizing enterocolitis.坏死性小肠结肠炎
N Engl J Med. 2011 Jan 20;364(3):255-64. doi: 10.1056/NEJMra1005408.

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