B. 支气管败血波氏杆菌所致的必须性脓胸，病例报告。
B. Bronchiseptica empyema necessitans, a case report.
作者信息
Wray Samantha, Tabliago Nikko Rowe A, Lueking Richard
机构信息
Division of Hospital Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave 8th Floor, Charleston, SC, 29425, USA.
Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
出版信息
BMC Pulm Med. 2025 May 9;25(1):226. doi: 10.1186/s12890-025-03670-5.
BACKGROUND
Empyema necessitans is an uncommon complication of an empyema, where pus in the pleural cavity extends into the chest wall. Both medical and surgical management are required. Here we have identified the first reported case of empyema necessitans caused by Bordetella bronchiseptica.
CASE PRESENTATION
A 60-year-old female dog trainer initially presented with a right chest wall lesion. Imaging showed a right-sided empyema and chest wall fistulization. Multiple Gram stains and cultures isolated Bordetella bronchiseptica. After several courses of antibiotics, imaging showed a chronic pleural collection with communication to a chest wall gas-fluid collection resembling empyema necessitans. Culture re-demonstrated Bordetella bronchiseptica. She was given a six-week course of oral moxifloxacin and underwent a Clagett window.
CONCLUSIONS
While Bordetella bronchiseptica has been previously exclusive to animals, it is an emerging zoonosis. Empyema necessitans because of repeated animal exposure is an unusual complication that had yet to be seen with this microorganism.
背景
脓胸穿破胸壁是脓胸的一种罕见并发症，即胸膜腔内的脓液蔓延至胸壁。药物和手术治疗均有必要。在此，我们报告了首例由支气管败血博德特氏菌引起的脓胸穿破胸壁病例。
病例介绍
一名60岁的女性训犬师最初因右胸壁病变前来就诊。影像学检查显示右侧脓胸和胸壁瘘管形成。多次革兰氏染色和培养均分离出支气管败血博德特氏菌。经过几个疗程的抗生素治疗后，影像学检查显示有慢性胸腔积液，并与一个类似脓胸穿破胸壁的胸壁气液积聚相通。培养结果再次证实为支气管败血博德特氏菌。给予她为期六周的口服莫西沙星疗程，并进行了克拉吉特开窗术。
结论
虽然支气管败血博德特氏菌以前仅见于动物，但它是一种新出现的人畜共患病。因反复接触动物而导致的脓胸穿破胸壁是一种不寻常的并发症，此前尚未在这种微生物感染中见到过。
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