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社区获得性高毒力菌株引起的严重颅内感染:一例报告

Severe intracranial infection caused by community-acquired hypervirulent : A case report.

作者信息

Ye Gongjie, Yang Lei, Dong Zhouzhou

机构信息

Department of Intensive Care Unit, Ningbo Medical Center Lihuili Hospital, Ningbo University, 1111 Jiangnan Road, Yinzhou District, Ningbo, Zhejiang Province 315040, China.

Department of Rehabilitation, Zhenhai Longsai Hospital, 6 Gulou West Road, Chengguan, Zhaobaoshan Street, Zhenhai District, Ningbo City, Zhejiang Province 315299, China.

出版信息

IDCases. 2023 Sep 30;34:e01902. doi: 10.1016/j.idcr.2023.e01902. eCollection 2023.

Abstract

Hypervirulent (HvKp) is a dynamic pathotype characterized by heightened mucoviscosity and virulence, typically afflicting individuals within the community, who commonly exhibit good health. We presented a case study of a 65-year-old male with diabetes who developed community acquired pneumonia, septic shock, and intracranial infection. The diagnosis was established through cranial magnetic resonance imaging (MRI), typical clinical presentation, and biological culture. The presence of HvKp infection was confirmed by cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) and blood culture. Treatment consisted of Amikacin 0.8 g qd in combination with meropenem 2.0 g q8h, based on drug sensitivity testing. The patient experienced symptom relief, with the CSF becoming clear and the elimination of the pathogen, ultimately resulting in a successful recovery. The clinical data, diagnosis, and treatment of the patient were documented, and a review of the literature was conducted to offer clinical guidance regarding the intracranial infection resulting from community-acquired HvKp.

摘要

高毒力肺炎克雷伯菌(HvKp)是一种动态致病型,其特征是黏液黏稠度和毒力增强,通常感染社区中一般健康的个体。我们报告了一例65岁男性糖尿病患者的病例研究,该患者发生了社区获得性肺炎、感染性休克和颅内感染。通过头颅磁共振成像(MRI)、典型临床表现和生物培养确诊。脑脊液(CSF)宏基因组下一代测序(mNGS)和血培养证实存在HvKp感染。根据药敏试验,治疗方案为阿米卡星0.8 g每日1次联合美罗培南2.0 g每8小时1次。患者症状缓解,脑脊液变清,病原体清除,最终成功康复。记录了该患者的临床资料、诊断和治疗过程,并进行了文献复习,以提供关于社区获得性HvKp所致颅内感染的临床指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7565/10551834/a7e5d552a90a/gr1.jpg

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