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一名乳腺癌患者中引起胆囊炎伴菌血症的罕见病原体

A Rare Organism Causing Cholecystitis With Bacteremia in a Breast Cancer Patient.

作者信息

Ghaly Mina, Zakala Alyssa, Penmethsa Kavya, Johnson-Pich Kristy D

机构信息

Internal Medicine, Southeast Health Medical Center, Dothan, USA.

Research, Alabama College of Osteopathic Medicine, Dothan, USA.

出版信息

Cureus. 2024 Feb 20;16(2):e54549. doi: 10.7759/cureus.54549. eCollection 2024 Feb.

Abstract

, a gram-negative, rod-shaped, anaerobic bacterium, is a rare cause of human disease. species have been known to mostly cause pulmonary disease in agricultural workers as they are native to select crops and wild animal furs. However, in very few documented cases, has been discovered as the source of nosocomial infections, usually in the setting of an immunocompromised host. This case report details the clinical course of a 62-year-old immunocompromised female with stage 3 breast cancer presenting with acute cholecystitis and bacteremia and the unexpected discovery of in peripheral and chemotherapy port blood cultures. After appropriate management and susceptibility testing, the patient fortunately recovered with initial cefepime and eventual levofloxacin to target the species. To our knowledge, this is the third documented case worldwide of isolated from cholecystitis with associated bacteremia and the first documented case in North America. Of special interest, a few months after her infection, the patient was found to be free of breast cancer.  species are known to contain levan, an exopolysaccharide, that has been seen to upregulate tumor suppressor genes. This should be considered in the future management and research of infections.

摘要

是一种革兰氏阴性、杆状厌氧菌,是人类疾病的罕见病因。已知该菌种主要在农业工人中引发肺部疾病,因为它们原产于特定作物和野生动物皮毛。然而,在极少数有记录的病例中,已发现它是医院感染的源头,通常发生在免疫功能低下的宿主身上。本病例报告详细描述了一名62岁患有3期乳腺癌的免疫功能低下女性,她因急性胆囊炎和菌血症就诊,在外周血和化疗端口血培养中意外发现了。经过适当的治疗和药敏试验,患者幸运地康复,最初使用头孢吡肟,最终使用左氧氟沙星来针对该菌种。据我们所知,这是全球第三例从伴有菌血症的胆囊炎中分离出该菌种的记录病例,也是北美首例记录病例。特别值得注意的是,在她感染几个月后,发现该患者乳腺癌已痊愈。已知该菌种含有果聚糖,一种胞外多糖,已观察到它能上调肿瘤抑制基因。在未来对该菌种感染的管理和研究中应考虑到这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a93/10955448/48f66505dbbc/cureus-0016-00000054549-i01.jpg

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