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患者出现对治疗无反应并进展为骨髓炎的脓肿:一种罕见病因

Patient Presenting with Abscess Unresponsive to Treatment and Progressive to Osteomyelitis: A Rare Cause .

作者信息

Cetin Fatma Tugba, Gundeslioglu Ozlem Ozgur, Bakanoglu Emel, Ummuhan Cay, Alabaz Derya, Gumus Hale, Kibar Filiz, Kundakci Bugra

机构信息

Department of Pediatric Infection, Cukurova University Faculty of Medicine, Adana, Türkiye.

Department of Microbiology, Cukurova University Faculty of Medicine, Adana, Türkiye.

出版信息

Sisli Etfal Hastan Tip Bul. 2024 Jun 28;58(2):258-261. doi: 10.14744/SEMB.2023.70194. eCollection 2024.

Abstract

Glanders is a rare zoonotic disease caused by (B. mallei). can cause pneumonia, abscesses, osteomyelitis in severe cases, sepsis, and even death in humans. In this report, we present a 15-year-old male patient living in a rural area who was diagnosed with glanders. The patient, who did not have any previous disease, was followed up with a diagnosis of pneumonia in the hospital, where he was admitted with complaints of cough and abdominal pain and presented to us with pain, redness, and swelling in his leg. Magnetic resonance imaging of the lower extremity revealed osteomyelitis in the fourth and fifth metatarsals of the right foot. growth was detected in the abscess culture. Meropenem treatment was started. The patient's symptoms regressed with treatment. The patient was discharged with oral ciprofloxacin for eradication. Glanders are usually transmitted through direct contact with infected animals, especially single-hoofed animals such as horses, or through inhalation of aerosols containing B. mallei. It is a rare disease-causing pneumonia and abscesses and can be life-threatening in severe cases. Diagnosis of glanders is difficult because the initial symptoms are non-specific. Isolation of in culture is the gold standard for diagnosing the disease. There is no clear recommendation for treating glanders and imipenem; meropenem ceftazidime can be used based on antibiotic susceptibility tests.

摘要

鼻疽是由鼻疽杆菌引起的一种罕见人畜共患病。严重时可导致人类肺炎、脓肿、骨髓炎、败血症甚至死亡。在本报告中,我们介绍了一名居住在农村地区的15岁男性患者,他被诊断患有鼻疽。该患者既往无任何疾病,因咳嗽和腹痛入院,在医院被诊断为肺炎,随后出现腿部疼痛、发红和肿胀。下肢磁共振成像显示右脚第四和第五跖骨骨髓炎。脓肿培养物中检测到鼻疽杆菌生长。开始使用美罗培南治疗。患者症状经治疗后消退。患者出院时口服环丙沙星以根除感染。鼻疽通常通过直接接触受感染动物传播,尤其是马等单蹄动物,或通过吸入含有鼻疽杆菌的气溶胶传播。它是一种罕见的导致肺炎和脓肿的疾病,严重时可危及生命。鼻疽的诊断很困难,因为初始症状不具特异性。在培养物中分离出鼻疽杆菌是诊断该病的金标准。对于鼻疽的治疗没有明确的推荐药物,亚胺培南、美罗培南、头孢他啶可根据药敏试验使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2921/11249987/00b0fb142eda/SEMB-58-258-g001.jpg

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