Ebedes Dominique M, Caputo-Seidler Jennifer
Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
Cureus. 2024 Jun 11;16(6):e62146. doi: 10.7759/cureus.62146. eCollection 2024 Jun.
() is a gram-positive, facultative anaerobic bacterium that appears as cocci in chains and commonly causes skin infections and pharyngitis. Here, we present a very uncommon case of cholangitis associated with invasive infection in a 34-year-old man with metastatic pancreatic adenocarcinoma who presented with fever, right upper quadrant pain, jaundice, altered mental status, and hypotension. The patient underwent a percutaneous transhepatic cholangiogram, showing moderate dilatation of intrahepatic biliary ducts with obstruction of the proximal common bile duct, and an internal/external biliary drain was placed to allow for the flow of bile. Blood cultures grew . Biliary fluid culture obtained at the time of drain placement grew , , and . The patient was treated with ampicillin-sulbactam and fluconazole. While the patient recovered from his sepsis, he died within weeks of diagnosis due to complications of metastatic disease.
（）是一种革兰氏阳性兼性厌氧菌，呈链状球菌，通常引起皮肤感染和咽炎。在此，我们报告一例非常罕见的胆管炎病例，该病例与一名34岁转移性胰腺腺癌男性患者的侵袭性感染有关，患者表现为发热、右上腹疼痛、黄疸、精神状态改变和低血压。患者接受了经皮经肝胆管造影，显示肝内胆管中度扩张，近端胆总管梗阻，并放置了内外胆管引流管以促进胆汁流动。血培养生长出……引流管放置时获得的胆汁液培养生长出……、……和……。患者接受了氨苄西林 - 舒巴坦和氟康唑治疗。虽然患者从脓毒症中康复，但由于转移性疾病的并发症，在诊断后数周内死亡。
