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新型冠状病毒肺炎合并肝脓肿的诊断与治疗:1例病例报告及文献综述

Diagnosis and treatment of COVID-19 complicated with liver abscess: A case report and literature review.

作者信息

Li Fan, Jiang Xueqiang, Liu Yanwei, Wang Wan, Zhang Congyu

机构信息

Department of General Practice, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China.

Department of Infectious Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China.

出版信息

Medicine (Baltimore). 2025 Jan 17;104(3):e40839. doi: 10.1097/MD.0000000000040839.

Abstract

RATIONALE

Novel coronavirus pneumonia is spreading in many countries and regions. Coronavirus disease (COVID-19) is characterized by rapid onset, high infectivity, rapid progression, and variably effective treatment.

PATIENT CONCERNS

One 63-year-old woman presented to the fever clinic of our hospital on February 10, 2020, due to a fever for 12 days.

DIAGNOSES

COVID-19 complicated with liver abscess.

INTERVENTIONS

A case report of a patient with COVID-19 complicated with liver abscess admitted to our hospital was used to explore the treatment methods for COVID-19 complicated with bacterial liver abscess. The sepsis caused by pulmonary viral infection and liver bacterial infection were correctly distinguished, and the patient was cured and discharged after targeted treatment, abscess, and pleural puncture and drainage.

OUTCOMES

The patient was cured with a normal temperature is >3 days and coronavirus 3 consecutive negative nucleic acid detection.

LESSONS

COVID-19, elderly critically ill patients may be prone to rapid onset, complex disease, multiple organ damage, prolonged hospital stay, and high mortality. In the treatment of such COVID-19 patients, holistic thinking is required, pathology may not be limited to the lung, but may affect other organs, and treatment guidelines should not be blindly followed. Medication may need to be individualized for patients with COVID-19 complicated with liver abscess.

摘要

理由

新型冠状病毒肺炎正在许多国家和地区传播。冠状病毒病(COVID-19)的特点是起病迅速、传染性强、进展快且治疗效果不一。

患者关注

一名63岁女性因发热12天于2020年2月10日到我院发热门诊就诊。

诊断

COVID-19合并肝脓肿。

干预措施

以我院收治的1例COVID-19合并肝脓肿患者的病例报告,探讨COVID-19合并细菌性肝脓肿的治疗方法。正确区分肺部病毒感染和肝脏细菌感染所致的脓毒症,经针对性治疗、脓肿及胸腔穿刺引流后患者治愈出院。

结果

患者体温正常>3天且冠状病毒核酸检测连续3次阴性治愈。

经验教训

COVID-19老年重症患者可能易出现起病迅速、病情复杂、多器官损害、住院时间延长及死亡率高的情况。在治疗此类COVID-19患者时,需要整体思维,病变可能不限于肺部,还可能累及其他器官,不应盲目遵循治疗指南。对于COVID-19合并肝脓肿的患者,用药可能需要个体化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5630/11749645/7567b43e7f97/medi-104-e40839-g001.jpg

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