Osório Catarina, Silva Diogo, Teles Luís, Ferreira Tiago, Nora Mário
General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT.
Intensive Care Unit, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PRT.
Cureus. 2023 Jan 30;15(1):e34365. doi: 10.7759/cureus.34365. eCollection 2023 Jan.
( ) and () are pathogenic human bacteria. sepsis with intravascular hemolysis is a catastrophic process with an extremely high mortality rate (70 to 100%). A 74-year-old male submitted to an elective laparoscopic cholecystectomy due to cholelithiasis and develops severe abdominal pain only 10 hours after being discharged from hospital. He was admitted to the emergency department with associated jaundice, fever, and hematuria. On arrival, his hemoglobin level was 9.2 g/dL but fell to 3.4g/dL within two hours. Massive intravascular hemolysis was diagnosed and a liver abscess with gas gangrene was shown in the contrast-enhanced computed tomographic. Despite proper management, a fatal outcome was unavoidable and the patient died eight ours later. Microbiological examination isolated C. and K. o Liver abscesses caused by and are extremely rare complications of laparoscopic cholecystectomy. Early recognition and prompt antibiotic therapy as well as control of septic focus are essential to minimize this fatal outcome.
（ ）和（ ）是致病性人类细菌。伴有血管内溶血的败血症是一个灾难性过程，死亡率极高（70%至100%）。一名74岁男性因胆结石接受择期腹腔镜胆囊切除术，出院仅10小时后就出现严重腹痛。他因伴有黄疸、发热和血尿被收入急诊科。入院时，他的血红蛋白水平为9.2g/dL，但两小时内降至3.4g/dL。诊断为大量血管内溶血，增强计算机断层扫描显示肝脓肿合并气性坏疽。尽管进行了适当治疗，但仍无法避免致命结局，患者八小时后死亡。微生物学检查分离出了（ ）菌和（ ）菌。由（ ）菌和（ ）菌引起的肝脓肿是腹腔镜胆囊切除术极为罕见的并发症。早期识别、及时抗生素治疗以及控制感染源对于将这种致命结局降至最低至关重要。
