Wu Gui-Xian, Zhou Jian-Ya, Hong Wei-Jun, Huang Jing, Yan Shuang-Quan
Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province, Zhejiang University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou 318050, Zhejiang Province, China.
Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
World J Clin Cases. 2022 Oct 16;10(29):10565-10574. doi: 10.12998/wjcc.v10.i29.10565.
is a food-borne disease, which is rarely prevalent in the normal population; it mostly occurs in pregnant women, newborns, immunodeficiency patients, and the elderly. The main manifestations of this disease in patients include sepsis, meningitis, , and the mortality rate remains high, although the onset of meningitis is relatively insidious.
A 75-year-old man presented with a fever for 1 wk and was admitted to the hospital for diagnosis and management of a lung infection. His condition improved after receiving anti-infective treatment for 2 wk. However, soon after he was discharged from the hospital, he developed fever again, and gradually developed various neurological symptoms, impaired consciousness, and stiff neck. Thereafter, through the cerebrospinal fluid metagenomic testing and blood culture, the patient was diagnosed with meningitis and sepsis. The patient died after being given active treatment, which included penicillin application and invasive respiratory support.
This case highlights the ultimate importance of early identification and timely application of the various sensitive antibiotics, such as penicillin, vancomycin, meropenem, Therefore, for high-risk populations with unknown causes of fever, multiple blood cultures, timely cerebrospinal fluid examination, and metagenomic detection technology can assist in confirming the diagnosis quickly, thereby guiding the proper application of antibiotics and improving the prognosis.
[疾病名称]是一种食源性疾病,在正常人群中很少流行;它主要发生在孕妇、新生儿、免疫缺陷患者和老年人中。该疾病在患者中的主要表现包括败血症、脑膜炎等,尽管脑膜炎的发病相对隐匿,但死亡率仍然很高。
一名75岁男性因发热1周入院,诊断并治疗肺部感染。接受抗感染治疗2周后病情好转。然而,出院后不久他再次发热,并逐渐出现各种神经症状、意识障碍和颈部僵硬。此后,通过脑脊液宏基因组检测和血培养,该患者被诊断为[疾病名称]脑膜炎和败血症。在给予包括应用青霉素和有创呼吸支持在内的积极治疗后,患者死亡。
该病例凸显了早期识别并及时应用各种敏感抗生素(如青霉素、万古霉素、美罗培南等)的至关重要性。因此,对于病因不明发热的高危人群,多次血培养、及时的脑脊液检查和宏基因组检测技术有助于快速确诊,从而指导合理应用抗生素并改善预后。