Pauls Stradiņš Clinical University Hospital, 13 Pilsoņu iela, LV-1002 Riga, Latvia.
Department of Internal Diseases, Riga Stradiņš University, 16 Dzirciema iela, LV-1007 Riga, Latvia.
Medicina (Kaunas). 2023 Apr 16;59(4):771. doi: 10.3390/medicina59040771.
A 66-year-old female patient was hospitalized with severe COVID-19 pneumonia, which led to hypoxia requiring oxygen support with high-flow nasal cannulae. She received anti-inflammatory treatment with a 10-day dexamethasone 6 mg PO course and a single infusion of IL-6 monoclonal antibody tocilizumab 640 mg IV. Treatment led to gradual reduction of oxygen support. However, on Day 10, she was found to have bacteremia with epidural, psoas, and paravertebral abscesses as the source. Targeted history taking revealed a dental procedure for periodontitis 4 weeks prior to hospitalization as the probable source. She received an 11-week antibiotic treatment, which led to resolution of the abscesses. This case report highlights the importance of individual infection risk assessment before the initiation of immunosuppressive treatment for COVID-19 pneumonia.
一位 66 岁女性患者因严重 COVID-19 肺炎住院，导致低氧血症需要高流量鼻导管吸氧支持。她接受了为期 10 天的地塞米松 6 mg PO 疗程和单次静脉注射 IL-6 单克隆抗体托珠单抗 640 mg 的抗炎治疗。治疗导致氧支持逐渐减少。然而，在第 10 天，发现她患有菌血症，硬膜外、腰大肌和椎旁脓肿是感染源。有针对性的病史调查显示，她在住院前 4 周因牙周炎进行了牙科手术，这可能是感染源。她接受了为期 11 周的抗生素治疗，脓肿得到了治愈。本病例报告强调了在 COVID-19 肺炎开始免疫抑制治疗之前，对个体感染风险进行评估的重要性。
