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病例报告:烧伤患儿中产毒白喉棒状杆菌引起的血流感染和革兰氏阴性菌败血症。

Case Report: Bloodstream Infection with Toxigenic Corynebacterium diphtheriae and Gram-Negative Sepsis in a Child with Burns.

机构信息

Department of Microbiology, JIPMER, Puducherry, India.

Department of Paediatrics, JIPMER, Puducherry, India.

出版信息

Am J Trop Med Hyg. 2022 Aug 29;107(4):930-933. doi: 10.4269/ajtmh.21-1233. Print 2022 Oct 12.

Abstract

Corynebacterium (C.) diphtheriae is the agent for a contagious infection, diphtheria. It may manifest as pharyngitis with pseudomembrane formation and cervical lymphadenopathy, cutaneous infection, or as an asymptomatic carrier. Corynebacterium (C.) diphtheriae is not an invasive organism and it remains in the superficial layers of skin lesions and respiratory mucosa. Systemic complications, such as bacteremia, are rare. We report a case of toxigenic C. diphtheriae detected from blood culture of a 1-year-old male patient with burns, who succumbed to the infection after 8 days of stay in the hospital. Patient did not have specific clinical features suggestive of diphtheria. Initial identification of C. diphtheriae was done based on culture, Albert stain findings, biochemical tests and subsequently toxigenicity testing was done by polymerase chain reaction. Although diphtheria vaccination in infancy is universally recommended since the creation of the Expanded Program on Immunization in the 1970s, there have been reports of toxigenic strains of C. diphtheriae in a considerable number of cases. Rapid and accurate identification of C. diphtheriae infection is crucial to prevent mortality. Continued surveillance for diphtheria is needed to reduce transmission and mortality rates.

摘要

白喉棒状杆菌(C.)是一种传染性感染的病原体,即白喉。它可能表现为假膜形成和颈淋巴结病的咽炎、皮肤感染,或无症状携带者。白喉棒状杆菌(C.)不是侵入性生物,它存在于皮肤损伤和呼吸道黏膜的浅层。全身并发症,如菌血症,很少见。我们报告了一例从一名 1 岁男性烧伤患者的血培养中检测到的产毒白喉棒状杆菌,该患者在住院 8 天后因感染而死亡。患者没有特定的临床特征提示白喉。最初根据培养、Albert 染色结果、生化试验鉴定白喉棒状杆菌,随后通过聚合酶链反应进行产毒性试验。尽管自 20 世纪 70 年代扩大免疫规划以来普遍建议在婴儿期接种白喉疫苗,但在相当多的病例中仍有产毒白喉棒状杆菌的报告。快速准确地识别白喉棒状杆菌感染对于预防死亡率至关重要。需要继续监测白喉,以降低传播和死亡率。

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