Birlutiu Victoria, Birlutiu Rares-Mircea, Dobritoiu Elena Simona
Faculty of Medicine, Lucian Blaga University of Sibiu, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania.
County Clinical Emergency Hospital, 550245 Sibiu, Romania.
Microorganisms. 2023 Aug 24;11(9):2143. doi: 10.3390/microorganisms11092143.
is a Gram-negative facultative anaerobic bacillus identified from water sources and later from food (onions, cream, unpasteurized milk, and Spanish pork sausages), which, under certain circumstances, can cause infections in humans, especially in immunocompromised patients. Few cases of human infections have been reported in the literature, such as endophthalmitis, urinary tract infection, pyonephrosis, and sepsis. We describe the case of a 69-year-old Caucasian male patient who lives in an urban environment and presents himself to the emergency department with chills, fever, myalgias, marked physical asthenia, dry cough, dyspnea, symptoms for which he is tested and confirmed with SARS-CoV-2 infection using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) from nasal and pharyngeal swabs, after being admitted the same day (25 May 2023) to the Infectious Diseases Clinic from the County Clinical Emergency Hospital Sibiu, Romania. At the time of admission, a pulmonary computerized tomography (CT) scan was performed, which revealed a severity score of 10 out of 25. In the second week of the disease, the patient presents with hemoptysis, from which bacteriological examinations are carried out, and and are identified. The evolution was slowly favorable under antiviral treatment, corticotherapy, antibiotic therapy (in the absence of the identified etiology, initially meropenem was administered in association with linezolid, and then ceftazidime-avibactam), voriconazole, anakinra, salbutamol inhaler, inhalation corticosteroids, with slow reduction in oxygen requirement, the patient continued oxygen therapy at home after discharge with a flow rate of 5 L/minute. During the third harvesting of sputum samples, was isolated along with , both strains of low-virulence species, and maintained susceptibility to antibiotics. In the context of an immunosuppressed patient with previous pulmonary surgery for actinomycosis, chronic obstructive pulmonary disease, and bronchiectasis, all these conditions are favorable for biofilm formation. remains a pathogen rarely isolated in human pathology, but we should pay more attention, especially in the immunosuppressed patient, where it can be responsible for an extremely serious clinical picture.
是一种革兰氏阴性兼性厌氧杆菌，最初从水源中发现，后来在食物（洋葱、奶油、未巴氏杀菌牛奶和西班牙猪肉香肠）中也有发现。在某些情况下，它可导致人类感染，尤其是免疫功能低下的患者。文献中报道的人类感染病例很少，如眼内炎、尿路感染、肾积脓和败血症。我们描述了一例69岁的白种男性患者，他生活在城市环境中，因寒战、发热、肌痛、明显身体虚弱、干咳、呼吸困难到急诊科就诊。当天（2023年5月25日）从罗马尼亚锡比乌县临床急诊医院传染病诊所收治后，通过对鼻拭子和咽拭子进行实时逆转录聚合酶链反应（RT-PCR）检测，确诊为感染新型冠状病毒。入院时进行了肺部计算机断层扫描（CT），严重程度评分为25分中的10分。在疾病的第二周，患者出现咯血，进行了细菌学检查，鉴定出了[具体细菌名称1]和[具体细菌名称2]。在抗病毒治疗、皮质激素治疗、抗生素治疗（在未明确病因的情况下，最初联合使用美罗培南和利奈唑胺，然后使用头孢他啶-阿维巴坦）、伏立康唑、阿那白滞素治疗、沙丁胺醇吸入器、吸入性皮质类固醇治疗下，病情逐渐好转，氧需求缓慢降低，患者出院后在家中继续以5升/分钟的流速进行氧疗。在第三次采集痰液样本时，分离出了[具体细菌名称1]和[具体细菌名称2]，这两种菌株均为低毒力菌种，且对抗生素保持敏感。对于一名既往因放线菌病进行过肺部手术、患有慢性阻塞性肺疾病和支气管扩张的免疫抑制患者，所有这些情况都有利于生物膜形成。[具体细菌名称]仍然是人类病理学中很少分离出的病原体，但我们应该更加关注，尤其是在免疫抑制患者中，它可能导致极其严重的临床症状。
