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肺炎继发下消化道缺血性坏死:一例报告

pneumonia followed by lower gastrointestinal ischemic necrosis: a case report.

作者信息

Shao Shifeng, Liu Jun, Wu Zhenbing, Wu Shasha

机构信息

Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Research Institute of Surgery, Chongqing, China.

出版信息

Front Med (Lausanne). 2025 Jan 8;11:1394897. doi: 10.3389/fmed.2024.1394897. eCollection 2024.

Abstract

BACKGROUND

Psittacosis, also known as parrot fever, is an uncommon infectious disease caused by (C. psittaci). While infections are usually not life-threatening, the pathogenesis and associated complications are not yet fully understood.

CASE DESCRIPTION

A 54-year-old male was hospitalized due to a cough, accompanied by expectoration and dyspnea. After admission, the patient's breathing rapidly deteriorated, and despite the use of a ventilator, it was challenging to maintain respiratory function. While initiating extracorporeal membrane oxygenation (ECMO) and empirical anti-infection treatments, the alveolar lavage fluid was collected and examined by metagenomics next generation sequencing (mNGS). The mNGS result indicated . Subsequently, the anti-infection regimen was immediately adjusted. The respiratory function improved on the 13th day after admission, and ECMO was withdrawn. However, the patient developed abdominal distension and intestinal edema. After intravenous infusion therapy, intestinal ischemia and necrosis occurred and surgical resection was performed. The patient's condition improved after the operation and he was transferred to a local hospital for rehabilitation.

CONCLUSION

This case report demonstrates the development of intestinal ischemic necrosis following severe pneumonia. This unique association has not been reported previously and highlights the importance of potential gastrointestinal complications in severe pneumonia, which are often underestimated. Timely diagnoses and treatments of such infections and complications are necessary to achieve favorable clinical outcomes.

摘要

背景

鹦鹉热,又称鹦鹉病,是一种由鹦鹉热衣原体引起的罕见传染病。虽然鹦鹉热衣原体感染通常不会危及生命,但其发病机制和相关并发症尚未完全明确。

病例描述

一名54岁男性因咳嗽、咳痰伴呼吸困难入院。入院后,患者呼吸迅速恶化,尽管使用了呼吸机,维持呼吸功能仍具有挑战性。在启动体外膜肺氧合(ECMO)和经验性抗感染治疗的同时,采集肺泡灌洗液并通过宏基因组下一代测序(mNGS)进行检测。mNGS结果显示……随后,立即调整抗感染方案。入院第13天呼吸功能改善,ECMO撤除。然而,患者出现腹胀和肠水肿。静脉输液治疗后,发生肠缺血坏死并进行了手术切除。术后患者病情好转,转至当地医院康复。

结论

本病例报告显示了严重鹦鹉热衣原体肺炎后发生肠缺血坏死。这种独特的关联此前未见报道,凸显了严重鹦鹉热衣原体肺炎潜在胃肠道并发症的重要性,而这些并发症往往被低估。及时诊断和治疗此类感染及并发症对于取得良好的临床结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d006/11751233/dc77f7b75393/fmed-11-1394897-g0001.jpg

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