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伤寒沙门菌感染所致心包脓肿

Pericardial Abscess Due to Salmonella Typhi Infection.

作者信息

Zhang Manli, Gao Chunming

机构信息

Department of Infectious Diseases, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.

Core Cooperative Unit of National Clinical Research Center for Infectious Diseases, Bengbu, China.

出版信息

Am J Trop Med Hyg. 2024 Dec 24;112(3):544-547. doi: 10.4269/ajtmh.24-0441. Print 2025 Mar 5.

Abstract

Typhoid fever is a human-specific disease caused by subspecies of Salmonella enterica (Salmonella Typhi). It spreads through ingestion of contaminated food or water and is diagnosed through blood culture or bone marrow culture. It typically presents as an intestinal infection, with a few patients developing severe disseminated infections. Here, we report a rare case of purulent pericarditis secondary to S. Typhi infection. A 67-year-old elderly male suffered from recurrent fever, diarrhea, and abdominal pain for 7 days. Initial blood and stool cultures were positive for Salmonella, and a follow-up blood culture confirmed S. Typhi. Magnetic resonance imaging showed pericardial abscess and hepatic abscess. After pericardiocentesis, the pericardial fluid culture grew S. Typhi, confirming the diagnosis of pericardial abscess secondary to S. Typhi infection. After percutaneous drainage of the pericardial abscess and administration of effective antibiotics, the patient's symptoms improved significantly. He subsequently recovered and was discharged from the hospital. During follow-up, there were no further recurrences. Disseminated infection secondary to Salmonella Typhi is extremely rare but can lead to serious life-threatening conditions. Our patient was found to have pericardial abscess caused by S. Typhi. Effective and adequate antibiotics, along with pericardial abscess drainage, can improve symptoms, assist in diagnosis, and enhance quality of life.

摘要

伤寒热是一种由肠道沙门氏菌(伤寒沙门氏菌)亚种引起的人类特有的疾病。它通过摄入受污染的食物或水传播,通过血培养或骨髓培养进行诊断。它通常表现为肠道感染,少数患者会发展为严重的播散性感染。在此,我们报告一例罕见的伤寒沙门氏菌感染继发脓性心包炎的病例。一名67岁老年男性反复发热、腹泻和腹痛7天。初始血培养和粪便培养沙门氏菌呈阳性,后续血培养确诊为伤寒沙门氏菌。磁共振成像显示心包脓肿和肝脓肿。心包穿刺术后,心包液培养出伤寒沙门氏菌,确诊为伤寒沙门氏菌感染继发心包脓肿。在对心包脓肿进行经皮引流并给予有效的抗生素治疗后,患者症状明显改善。他随后康复并出院。随访期间未再复发。伤寒沙门氏菌继发的播散性感染极为罕见,但可导致严重的危及生命的状况。我们的患者被发现患有由伤寒沙门氏菌引起的心包脓肿。有效的足量抗生素以及心包脓肿引流可以改善症状、辅助诊断并提高生活质量。

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Pericardial Abscess Due to Salmonella Typhi Infection.伤寒沙门菌感染所致心包脓肿
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本文引用的文献

2
[Salmonella bacteremia and its disseminated infection should not be neglected].沙门菌血症及其播散性感染不容忽视。
Zhonghua Nei Ke Za Zhi. 2021 Feb 1;60(2):102-105. doi: 10.3760/cma.j.cn112138-20200321-00279.
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A Systematic Review on Antimicrobial Resistance among Typhi Worldwide.全球伤寒沙门氏菌的耐药性:系统综述
Am J Trop Med Hyg. 2020 Dec;103(6):2518-2527. doi: 10.4269/ajtmh.20-0258. Epub 2020 Sep 24.
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Jpn J Infect Dis. 2021 Mar 24;74(2):166-168. doi: 10.7883/yoken.JJID.2020.518. Epub 2020 Aug 31.
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Typhoid Fever in South Africa in an Endemic HIV Setting.南非艾滋病流行环境中的伤寒热
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