Hsu Megan D, Ta An Phuc D, Iwamoto Satori, Leo Alexis, Chu Gary
College of Medicine, California Northstate University, Elk Grove, USA.
Internal Medicine, Kaiser South Sacramento, Sacramento, USA.
Cureus. 2023 Dec 16;15(12):e50632. doi: 10.7759/cureus.50632. eCollection 2023 Dec.
Annually, millions of people worldwide are exposed to a species of bacteria that commonly causes gastroenteritis and in cases of immunocompromised individuals, can also lead to life-threatening complications. After stool cultures are obtained, the usual treatment for infectious diarrhea involves metronidazole and quinolones such as ciprofloxacin or levofloxacin. Quinolones are a family of broad-spectrum antibiotics known to be effective against various gram-negative infections that also include However, due to adverse side effects and bacterial resistance risks that may exist with medication use, they are no longer used as a first line. Our patient, initially treated with ceftriaxone for symptoms resembling bacterial meningitis, pneumonia, and infectious diarrhea, showed minimal to no improvement. Subsequent cerebral spinal fluid (CSF) ruled out meningitis while stool studies confirmed as the causative agent. A switch to levofloxacin resulted in a noticeable improvement in the patient's condition. This case emphasizes the importance of considering changes in antibiotic regimen from ceftriaxone to quinolones when faced with persistent infectious diarrhea, due to the high prevalence of ceftriaxone resistance in infections.
全世界每年有数百万人接触到一种通常会引起肠胃炎的细菌,对于免疫功能低下的个体,这种细菌还可能导致危及生命的并发症。在进行粪便培养后,感染性腹泻的常规治疗方法包括使用甲硝唑和喹诺酮类药物,如环丙沙星或左氧氟沙星。喹诺酮类是一类广谱抗生素,已知对各种革兰氏阴性感染有效,其中也包括……然而,由于用药可能存在的不良副作用和细菌耐药风险,它们不再被用作一线药物。我们的患者最初因出现类似细菌性脑膜炎、肺炎和感染性腹泻的症状而接受头孢曲松治疗,但症状改善甚微或没有改善。随后的脑脊液检查排除了脑膜炎,而粪便检查确诊……为病原体。改用左氧氟沙星后,患者的病情有了明显改善。该病例强调,由于……感染中头孢曲松耐药性的高发生率,面对持续性感染性腹泻时,考虑将抗生素治疗方案从头孢曲松改为喹诺酮类的重要性。