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维氏气单胞菌所致菌血症伴急性髓系白血病治疗过程:一例报告及文献复习

Aeromonas veronii-associated bacteremia in the course of treatment of acute myeloid leukemia: a case report and review of the literature.

作者信息

Zhao Jiashan, Wu Tianjiao, Wang Songyun, Wang Huirui

机构信息

Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China.

The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.

出版信息

Discov Oncol. 2024 Sep 27;15(1):493. doi: 10.1007/s12672-024-01362-w.

Abstract

PURPOSE

This study aimed to report a case of acute myeloid leukemia (AML) complicated by Aeromonas veronii infection-induced bacteremia and to review relevant literature on the etiology, prevention, treatment, and prognosis of bacteremia in immunocompromised populations, aiming to reduce mortality in individuals with hematologic and other end-stage diseases and improve patient outcomes.

METHODS AND RESULTS

We reported the case of a 23-year-old male patient with relapsed AML characterized by AML1:ETO and ASXL positivity, classified as a high-risk group. The patient presented with fever, abdominal pain, diarrhea, nausea, and vomiting after consuming partially cooked fish. The patient was admitted with high leucocytes, C-reactive protein, procalcitonin, and interleukin-6 levels. Peripheral blood high-throughput sequencing (Next-Generation Sequencing NGS) confirmed infection with Aeromonas veronii, while an abdominal CT scan indicated a liver abscess with gas formation. Culture of the drainage fluid from the ultrasound-guided liver abscess puncture demonstrated growth of Aeromonas veronii. Based on the sensitivity results, the patient was treated with intravenous ciprofloxacin and cefoperazone-sulbactam. After treatment with antibiotics, blood transfusion, liver protection, and azacitidine 100 mg ih, combined with dry white sand(interferon alpha-1B, interleukin-2, and thalidomide), the critical condition of the patient improved, and he was discharged. This study was approved by the Ethics Committee of Medical Research in the Second Affiliated Hospital of Henan University of Science and Technology. Informed consent was obtained from this patient and we have obscured the patient's identifying information. All methods were carried out in accordance with relevant guidelines and regulations.

CONCLUSION

When patients with a recurrence of AML have a history of consuming or contacting aquatic products, clinicians should be vigilant about Aeromonas veronii infection. The presence of Aeromonas veronii in peripheral blood must alert clinicians to the possibility of severe sepsis and septic shock. Early diagnosis and prompt treatment are crucial to reducing patient mortality.

摘要

目的

本研究旨在报告1例急性髓系白血病(AML)合并维氏气单胞菌感染所致菌血症的病例,并复习免疫功能低下人群菌血症的病因、预防、治疗及预后的相关文献,以降低血液系统及其他终末期疾病患者的死亡率,改善患者结局。

方法与结果

我们报告了1例23岁复发性AML男性患者的病例,其特征为AML1:ETO和ASXL阳性,属于高危组。患者在食用未煮熟的鱼后出现发热、腹痛、腹泻、恶心和呕吐。患者入院时白细胞、C反应蛋白、降钙素原和白细胞介素-6水平升高。外周血高通量测序(二代测序,NGS)证实感染维氏气单胞菌,而腹部CT扫描显示肝脓肿并伴有气体形成。超声引导下肝脓肿穿刺引流液培养显示有维氏气单胞菌生长。根据药敏结果,患者接受静脉注射环丙沙星和头孢哌酮-舒巴坦治疗。经抗生素治疗、输血、保肝及皮下注射阿扎胞苷100 mg,并联合“干白沙”(α-1B干扰素、白细胞介素-2和沙利度胺)后,患者病情好转并出院。本研究经河南科技大学第二附属医院医学研究伦理委员会批准。获得了该患者的知情同意,我们已对患者的识别信息进行了模糊处理。所有方法均按照相关指南和规定进行。

结论

当复发性AML患者有食用或接触水产品史时,临床医生应警惕维氏气单胞菌感染。外周血中出现维氏气单胞菌必须提醒临床医生注意严重脓毒症和感染性休克的可能性。早期诊断和及时治疗对于降低患者死亡率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bc4/11436595/2bab54ee5b73/12672_2024_1362_Fig1_HTML.jpg

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