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一名肝硬化患者发生继发性腹膜炎,涉及一种新兴的真菌病原体。

Secondary peritonitis in a patient with cirrhosis involving , an emerging fungal pathogen.

作者信息

Feldman Erica B, Bellinghausen Amy L, Vodkin Irine E, Abeles Shira R, Kamdar Biren B

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 7381, La Jolla, CA 92093, USA.

Division of Gastroenterology, Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, Mail Code 0063, La Jolla, CA 92093, USA.

出版信息

IDCases. 2023 Feb 28;31:e01730. doi: 10.1016/j.idcr.2023.e01730. eCollection 2023.

Abstract

We present a case where a yeast, speciated from peritoneal fluid in a cirrhotic patient with secondary peritonitis. The patient, a man in his 60s with decompensated cirrhosis, was admitted for an upper gastrointestinal (GI) bleed. On admission, he was treated empirically for spontaneous bacterial peritonitis (SBP) but failed to improve with antibiotics. Serial paracenteses revealed polymicrobial peritonitis and rising peritoneal polymorphonuclear leukocytes (PMNs). These findings raised concerns for secondary peritonitis, prompting an abdominal computed tomography (CT) scan which revealed ischemic bowel. Among the peritoneal microbiota isolated, predominated. has only recently been reported as a human pathogen, previously it had only reported as a pathogen in bats[1,2].

摘要

我们报告了一例从一名患有继发性腹膜炎的肝硬化患者的腹腔积液中分离出酵母菌种的病例。该患者为一名60多岁的男性,患有失代偿期肝硬化,因上消化道出血入院。入院时,他接受了自发性细菌性腹膜炎(SBP)的经验性治疗,但抗生素治疗未能改善病情。连续腹腔穿刺术显示为多微生物性腹膜炎,腹腔多形核白细胞(PMN)增多。这些发现引发了对继发性腹膜炎的担忧,促使进行腹部计算机断层扫描(CT),结果显示肠道缺血。在分离出的腹腔微生物群中, 占主导地位。 直到最近才被报道为人类病原体,此前仅报道为蝙蝠中的病原体[1,2]。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c9c/9996382/a02ff943fd62/gr1.jpg

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