Singh Harjinder, Kaushal Jessica, Garcia Alejandro, Kak Vivek
Internal Medicine, Henry Ford Health System, Jackson, USA.
Internal Medicine, Bridgeport Hospital, Bridgeport, USA.
Cureus. 2024 May 11;16(5):e60082. doi: 10.7759/cureus.60082. eCollection 2024 May.
bacteremia arises due to skin inoculation from the external environment or translocation from the gastrointestinal tract. In the event of bacteremia, it tends to colonize in anaerobic environments due to its obligatory anaerobic nature. Its inoculation in the lung, albeit rare, can occur if an anaerobic nidus is created. In the presented case, the patient developed bacteremia andempyema in the area of lung necrosis caused by acute pulmonary embolism. He did not have any history of chest trauma, and the source of bacteremia was deemed to be via gut translocation. The patient was noted to have multiple gastric ulcers on endoscopy and jejunal wall thickening, which likely led to the bacterial translocation into the bloodstream. He underwent video-assisted thoracoscopic surgery-assisted decortication and intravenous antibiotics, eventually leading to clinical improvement. To identify the source of in the absence of penetrating trauma, a thorough gastrointestinal evaluation, including a colonoscopy, is warranted to identify the pathology leading to the gastrointestinal translocation.
菌血症可因外界环境的皮肤接种或胃肠道细菌移位而产生。发生菌血症时,由于其严格厌氧的特性,它倾向于在厌氧环境中定植。尽管罕见,但如果形成厌氧病灶,它可接种于肺部。在本病例中,患者因急性肺栓塞导致肺坏死区域发生菌血症和脓胸。他没有任何胸部外伤史,菌血症的来源被认为是通过肠道细菌移位。在内镜检查中发现患者有多处胃溃疡和空肠壁增厚,这可能导致细菌移位进入血液。他接受了电视辅助胸腔镜手术辅助的剥脱术和静脉使用抗生素治疗,最终临床症状改善。为了在没有穿透性创伤的情况下确定菌血症的来源,有必要进行全面的胃肠道评估,包括结肠镜检查,以确定导致胃肠道细菌移位的病变。