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老年女性猪链球菌引起的脑膜炎和脓毒症:一份符合 CARE 原则的病例报告。

Meningitis and sepsis caused by Streptococcus suis in an elderly woman: A CARE-compliant case report.

机构信息

Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, China.

The Eighth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Foshan City, Guangdong Province, China.

出版信息

Medicine (Baltimore). 2023 Oct 27;102(43):e35780. doi: 10.1097/MD.0000000000035780.

Abstract

RATIONALE

Streptococcus suis (S suis)-associated infections are uncommon but life-threatening diseases. The clinical manifestations vary from general symptoms of bacterial infection to fatal meningitis. The clinical manifestation and routine diagnostic testing is not specific enough to obtain well-time diagnosis.

PATIENT CONCERNS AND DIAGNOSIS

We report a case of meningitis and sepsis caused by S suis infection. A 70-year-old woman presented to our emergency department with generalized pain. After hospital admission, her condition rapidly deteriorated to fever, intracranial hypertension, and disturbance of consciousness. Examination of the blood and cerebrospinal fluid with metagenomic next-generation sequencing and bacterial cultures revealed S suis infection.

INTERVENTIONS AND OUTCOMES

After anti-infection therapy with meropenem and vancomycin, the patient recovered and was discharged from the hospital with no residual effects.

LESSONS

Human infections with S suis are extremely rare. If clinicians encounter a patient with fever, disturbance of consciousness, and intracranial hypertension, especially those who have been exposed to raw pork, S suis infection should be considered. Metagenomic next-generation sequencing can be a useful adjunct for the rapid diagnosis of S suis infection and aid in the planning of clinical treatment. Meanwhile, public health awareness is necessary to limit the risk of S suis infection.

摘要

背景

猪链球菌(S suis)相关感染并不常见,但可危及生命。其临床表现从一般细菌感染的全身症状到致命性脑膜炎各不相同。临床表现和常规诊断检测不够特异,无法及时作出诊断。

病例介绍

我们报告了一例由猪链球菌感染引起的脑膜炎和败血症。一名 70 岁女性因全身疼痛到我院急诊科就诊。入院后,其病情迅速恶化,出现发热、颅内压升高和意识障碍。对血液和脑脊液进行宏基因组二代测序和细菌培养显示为猪链球菌感染。

治疗经过

给予美罗培南和万古霉素抗感染治疗后,患者痊愈出院,无后遗症。

结论

人感染猪链球菌的情况极为罕见。如果临床医生遇到发热、意识障碍和颅内压升高的患者,尤其是有接触生猪肉的患者,应考虑猪链球菌感染。宏基因组二代测序可作为一种快速诊断猪链球菌感染的有用辅助手段,并有助于制定临床治疗方案。同时,有必要提高公众卫生意识,以降低猪链球菌感染的风险。

相似文献

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meningitis in China: a case report.中国的脑膜炎:一例报告。
Front Public Health. 2024 May 14;12:1369703. doi: 10.3389/fpubh.2024.1369703. eCollection 2024.

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