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由……引起的致命社区获得性血流感染:一例报告

Fatal community-acquired bloodstream infection caused by : A case report.

作者信息

Long Da-Li, Wang Yu-Hui, Wang Jin-Long, Mu Si-Jie, Chen Li, Shi Xian-Qing, Li Jian-Quan

机构信息

Intensive Care Unit, Guizhou Provincial People's Hospital, Guiyang 550000, Guizhou Province, China.

出版信息

World J Clin Cases. 2022 Mar 16;10(8):2474-2483. doi: 10.12998/wjcc.v10.i8.2474.

Abstract

BACKGROUND

() is an infective microorganism of worldwide concern because of its varied manifestations and life-threatening potential. Genetic analyses have revealed that subspecies of exhibit higher virulence and mortality. However, infections with subspecies are often misdiagnosed and underestimated in the clinic because of difficulties in distinguishing from its subspecies using routine tests. This case study reports the rapid and fatal effects of subspecies.

CASE SUMMARY

A 52-year-old male patient was febrile and admitted to hospital. Examinations excluded viral and fungal causes along with mycoplasma/chlamydia and parasitic infections. Bacterial cultures revealed blood-borne sensitive to carbapenem antibiotics, although corresponding treatment failed to improve the patient's symptoms. His condition worsened and death occurred within 72 h of symptom onset from sepsis shock. Application of the PMseq-DNA Pro high throughput gene detection assay was implemented with results obtained after death showing a mixed infection of and (). Clinical evidence suggested that rather than contributed to the patient's poor prognosis.

CONCLUSION

This is the first case report to show patient death from subspecies infection within a short period of time. This case provides a timely reminder of the clinical hazards posed by subspecies and highlights the limitations of classical laboratory methods in guiding anti-infective therapies for complex cases. Moreover, this report serves as reference for physicians diagnosing similar diseases and provides a recommendation to employ early genetic detection to aid patient diagnosis and management.

摘要

背景

()是一种引起全球关注的感染性微生物,因其表现多样且具有危及生命的可能性。基因分析表明,()的亚种具有更高的毒力和死亡率。然而,由于使用常规检测难以将()与其亚种区分开来,临床上()亚种感染常常被误诊和低估。本病例研究报告了()亚种的快速致命影响。

病例摘要

一名52岁男性患者发热入院。检查排除了病毒、真菌病因以及支原体/衣原体和寄生虫感染。细菌培养显示血行感染的()对碳青霉烯类抗生素敏感,尽管相应治疗未能改善患者症状。他的病情恶化,在症状出现后72小时内因脓毒症休克死亡。应用PMseq-DNA Pro高通量基因检测方法,死后获得的结果显示为()和()的混合感染。临床证据表明,导致患者预后不良的是()而非()。

结论

这是首例显示患者因()亚种感染在短时间内死亡的病例报告。该病例及时提醒了()亚种带来的临床危害,并突出了经典实验室方法在指导复杂病例抗感染治疗方面的局限性。此外,本报告为医生诊断类似疾病提供了参考,并建议采用早期基因检测以辅助患者诊断和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b1/8968595/164b3b3e86f1/WJCC-10-2474-g001.jpg

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