Bonda Sruthi, Lee Kevin, Rovig John, Asad Shadaba
Department of Internal Medicine, University of Nevada, Las Vegas, 1707 W Charleston Blvd. Suite 100, Las Vegas, NV 89102, United States.
Department of Infectious Disease, University Medical Center, 1800 W Charleston Blvd, Las Vegas, NV 89102, United States.
IDCases. 2022 May 20;29:e01516. doi: 10.1016/j.idcr.2022.e01516. eCollection 2022.
The species is a gram positive, anaerobic, rod-shaped microbe that is known to produce many toxins. Most infections by the species involve , , and . However, other types of species are also clinically relevant, such as and .
We discuss a case of a 79-year-old patient with a past medical history of prostate cancer and alcohol abuse who presented to the hospital after being found down. They were admitted to the ICU for septic shock, and initial blood cultures grew , , and A CT of the abdomen and pelvis with IV contrast showed pneumoperitoneum and a loculated pericolic fluid collection concerning for colon perforation. Initially the patient had a benign abdominal exam, but later developed significant distention and tenderness that required an emergent exploratory laparotomy and total abdominal colectomy. The patient was found to have three separate colon perforations, and no malignancy on histopathology.
is a highly virulent pathogen, and there are several cases reporting -associated endocarditis, aortitis, and endophthalmitis It is also associated with colon and hematologic malignancies and neutropenia. Common risk factors for include immunocompromised status, neutropenia, hematologic malignancy, exposure to beta-lactam antibiotics, cirrhosis, and intestinal mucosal damage. It seems to have low virulence and low mortality when treated correctly. It is important that any patient found to have bacteremia be evaluated for a gastrointestinal source and treated promptly and appropriately.
该菌种是一种革兰氏阳性、厌氧、杆状微生物，已知会产生多种毒素。该菌种引起的大多数感染累及[具体部位1]、[具体部位2]和[具体部位3]。然而，其他类型的该菌种在临床上也具有相关性，例如[具体类型1]和[具体类型2]。
我们讨论一例79岁患者，有前列腺癌和酗酒病史，被发现倒地后送至医院。他们因感染性休克入住重症监护病房，初始血培养培养出[具体菌种1]、[具体菌种2]和[具体菌种3]。腹部和盆腔增强CT显示气腹和结肠旁局限性液体积聚，怀疑有结肠穿孔。最初患者腹部检查无异常，但后来出现明显腹胀和压痛，需要紧急剖腹探查和全腹结肠切除术。患者被发现有三处独立的结肠穿孔，组织病理学检查未发现恶性肿瘤。
[具体菌种]是一种高毒力病原体，有几例报告了与[具体菌种]相关的感染性心内膜炎、主动脉炎和眼内炎。它还与结肠和血液系统恶性肿瘤以及中性粒细胞减少症有关。[具体菌种]的常见危险因素包括免疫功能低下状态、中性粒细胞减少症、血液系统恶性肿瘤、接触β-内酰胺类抗生素、肝硬化和肠黏膜损伤。如果治疗得当，其毒力似乎较低，死亡率也较低。任何被发现患有[具体菌种]菌血症的患者都必须评估是否存在胃肠道来源，并及时进行适当治疗，这一点很重要。
