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一名患有格林-巴利综合征的老年患者出现不明原因发热伴表皮葡萄球菌菌血症:病例报告

Staphylococcus epidermidis Bacteremia in an Older Patient With Guillain-Barré Syndrome With Fever of Unknown Origin: A Case Report.

作者信息

Nagayama Tomoe, Ohara Junya, Sano Chiaki, Ohta Ryuichi

机构信息

Family Medicine, International University of Health and Welfare Graduate School of Health Sciences, Tokyo, JPN.

Family Medicine, Unnan City Hospital, Unnan, JPN.

出版信息

Cureus. 2023 Sep 25;15(9):e45940. doi: 10.7759/cureus.45940. eCollection 2023 Sep.

Abstract

Guillain-Barré syndrome (GBS) is an immune-mediated disorder that affects the peripheral nerves, often leading to weakness, numbness, and paralysis. Although GBS does not induce immunosuppression, severe cases can render patients vulnerable to infection due to various complications. We present the case of a 70-year-old woman who developed GBS following a infection. The patient's prolonged GBS symptoms led to an immunocompromised state, resulting in sepsis due to bacteremia caused by methicillin-resistant . Respiratory muscle paralysis necessitated intubation and mechanical ventilation, predisposing the patient to aspiration pneumonia. Prolonged hospitalization increases the risk of infection, as exemplified by catheter-related bloodstream infections and respiratory bacterial colonization. Although GBS does not inherently suppress immunity, its complications, such as musculoskeletal and respiratory failure, can mimic immunodeficiency, necessitating comprehensive management. A system-based approach should address neurological deficits and potential complications, emphasizing collaboration among medical specialties. This case highlights the importance of recognizing GBS-related challenges and adopting a holistic strategy for effective patient care.

摘要

吉兰 - 巴雷综合征(GBS)是一种免疫介导的疾病,会影响周围神经,常导致无力、麻木和瘫痪。虽然GBS不会引起免疫抑制,但严重病例可能因各种并发症使患者易受感染。我们报告一例70岁女性在感染后发生GBS的病例。患者GBS症状持续时间长导致免疫功能受损状态,因耐甲氧西林菌血症引起败血症。呼吸肌麻痹需要插管和机械通气,使患者易患吸入性肺炎。长期住院增加了感染风险,如导管相关血流感染和呼吸道细菌定植所示。虽然GBS本身不会抑制免疫,但其并发症,如肌肉骨骼和呼吸衰竭,可模拟免疫缺陷,需要综合管理。基于系统的方法应解决神经功能缺损和潜在并发症,强调医学专科之间的协作。该病例突出了认识GBS相关挑战并采取整体策略以有效护理患者的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ef/10599601/b1b2786af154/cureus-0015-00000045940-i01.jpg

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