Feng Qiupeng, Yuan Hua, Ma Jin, Guo Zhiqiang, Xia Xiaohua, Zhao Guang
Department of Emergency Medicine, The First People's Hospital of Kunshan, Kunshan, China.
Jiangsu University Health Science Center, Kunshan, China.
Front Med (Lausanne). 2025 Jan 7;11:1511734. doi: 10.3389/fmed.2024.1511734. eCollection 2024.
A liver abscess caused by hypervirulent can lead to multiple invasive extrahepatic infections, including lung abscesses, endophthalmitis, brain abscesses, and necrotizing fasciitis. This condition, known as liver abscess invasion syndrome, progresses rapidly and is associated with severe illness, high disability rates, and significant mortality. However, bloodstream infections with co-infection involving carbapenem-resistant are exceedingly rare.
The Emergency Medicine Department of the First People's Hospital of Kunshan successfully treated a male patient diagnosed with liver, lung, and prostate abscesses. The patient underwent puncture and drainage, with analysis of the drainage fluid, sputum culture, and metagenomic next-generation sequencing (m-NGS) revealing a co-infection with blood-borne and . Guided by drug sensitivity test results, the patient received treatment with polymyxin and cefoperazone sodium-sulbactam sodium for infection control and liver protection. The treatment was successful, and the patient fully recovered and was discharged.
By reporting this rare case and highlighting the drug resistance of the bacteria, we propose a new diagnosis and treatment plan for managing combined with carbapenem-resistant infection, along with a literature review.
高毒力肝脓肿可导致多种侵袭性肝外感染，包括肺脓肿、眼内炎、脑脓肿和坏死性筋膜炎。这种情况被称为肝脓肿侵袭综合征，进展迅速，与严重疾病、高致残率和高死亡率相关。然而，合并耐碳青霉烯类感染的血流感染极为罕见。
昆山市第一人民医院急诊科成功治疗了一名被诊断为肝、肺和前列腺脓肿的男性患者。患者接受了穿刺引流，对引流液进行分析、痰培养和宏基因组下一代测序（m-NGS），结果显示存在血源性和感染。根据药敏试验结果，患者接受多粘菌素和头孢哌酮钠舒巴坦钠治疗以控制感染和保护肝脏。治疗成功，患者完全康复并出院。
通过报告这一罕见病例并强调细菌的耐药性，我们结合文献综述，提出了一种新的诊断和治疗方案，用于管理合并耐碳青霉烯类感染的情况。
