Yatomi Masakiyo, Hashimoto Chihiro, Kouno Shunichi, Hoshino Yuki, Yoshida Yuki, Hara Kentaro, Uno Shogo, Masubuchi Hiroaki, Miura Yosuke, Tsurumaki Hiroaki, Koga Yasuhiko, Sunaga Noriaki, Hisada Takeshi, Maeno Toshitaka
Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Gunma, Japan.
Department of Respiratory Medicine, Public Fujioka General Hospital, Fujioka, Gunma, Japan.
Am J Case Rep. 2024 Dec 10;25:e945283. doi: 10.12659/AJCR.945283.
BACKGROUND Most Fusobacterium necrophorum infections originate in the head and neck region. Infections originating from sites other than the head and neck are rare but are more common in older than in younger adults and have a higher mortality rate than that of infections originating from the head and neck region. CASE REPORT We present the case of a previously healthy 16-year-old female patient who developed bacteremia and pleural effusions with a burn ulcer on the lower leg but had no abnormality in the head and neck region. She sustained a second-degree burn injury on the left shin that remained untreated for several weeks, resulting in the development of Fusobacterium necrophorum bacteremia. She was admitted after developing fever, chest pain, and dyspnea. Blood culture revealed Fusobacterium necrophorum, but no abnormality was noted in the head and neck region, and a second-degree burn was observed on the left shin. She had bilateral pleural effusions assumed to result from a burn ulcer and was intravenously treated with tazobactam/piperacillin and therapeutic thoracentesis. She responded to therapy and made a full recovery. CONCLUSIONS While the origin of the Fusobacterium necrophorum infection in the burn ulcer could not be detected, this case report suggests that burn ulcers are a potential source of systemic Fusobacterium necrophorum infection and highlights the importance of early medical and surgical treatment and antimicrobial therapy.
背景 大多数坏死梭杆菌感染起源于头颈部区域。起源于头颈部以外部位的感染较为罕见,但在老年人中比在年轻人中更常见,且死亡率高于起源于头颈部区域的感染。病例报告 我们报告一例病例,一名既往健康的16岁女性患者出现菌血症和胸腔积液,小腿有烧伤溃疡,但头颈部区域无异常。她左小腿遭受二度烧伤,数周未治疗,导致坏死梭杆菌菌血症。她在出现发热、胸痛和呼吸困难后入院。血培养显示坏死梭杆菌,但头颈部区域未发现异常,左小腿可见二度烧伤。她双侧胸腔积液,推测由烧伤溃疡引起,接受了哌拉西林/他唑巴坦静脉治疗及治疗性胸腔穿刺术。她对治疗有反应并完全康复。结论 虽然无法检测到烧伤溃疡中坏死梭杆菌感染的来源,但本病例报告表明烧伤溃疡是坏死梭杆菌全身感染的潜在来源,并强调了早期药物和手术治疗以及抗菌治疗的重要性。