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菌血症导致酒精性肝硬化患者出现严重乳酸酸中毒和多器官功能衰竭:1例死亡病例报告

Bacteremia causing severe lactic acidosis and multiorgan failure in alcoholic cirrhosis: A report of a fatal case.

作者信息

Zeidan Zeidan A, Kumar Umesh, Mozammil Shafi, Alhanafi Hossam, AlJuaeed Majed, Harbi Sami Al, Harbi Abdulla Fayad Al, AlAsmari Abdulla, Abubaker Nusrida, AlZeed Nouf, AlZahrani Nadia, Khalild Salih, Althageel Mamdouh

机构信息

Infection Control Department, King Salman Hospital, Riyadh, Saudi Arabia.

Laboratory Department, King Salman Hospital, Riyadh, Saudi Arabia.

出版信息

IDCases. 2025 Jul 19;41:e02324. doi: 10.1016/j.idcr.2025.e02324. eCollection 2025.

Abstract

Non-O1, non-O139 (NOVC) infections can cause sepsis in patients with liver cirrhosis. NOVC bacteraemia is a rare condition, with the highest number of cases reported in Asia. Despite increasing recognition of non-O1, Non-O139 as emerging pathogens associated with gastroenteritis, wound infections, and septicaemia, there is limited knowledge on disease patterns, complications, and survival dynamics of the disease. Here, NOVC strains were isolated from an elderly female with a known history of alcoholic cirrhosis, who presented with severe abdominal pain and altered sensorium leading to hepatic coma. The patient was admitted to the intensive care unit (ICU) with a provisional diagnosis of acute-on-chronic liver failure (ascites, jaundice, coagulopathy, and hepatic encephalopathy) complicated by septic shock and multiorgan failure. Hepatitis panel (Hepatitis A IgM, Hepatitis B surface antigen, Anti-Hepatitis C antibody) and Human Immunodeficiency Virus (HIV) screening were negative. Despite aggressive supportive measures, the patient's condition deteriorated, and she succumbed to her illness on day 4 of ICU admission. Informed consent was obtained from the patient's relatives.

摘要

非O1、非O139(NOVC)感染可导致肝硬化患者发生败血症。NOVC菌血症是一种罕见病症,亚洲报告的病例数最多。尽管人们越来越认识到非O1、非O139是与肠胃炎、伤口感染和败血症相关的新兴病原体,但对于该疾病的发病模式、并发症和生存动态了解有限。在此,从一名有酒精性肝硬化病史的老年女性患者中分离出NOVC菌株,该患者出现严重腹痛和意识改变,进而发展为肝昏迷。患者因初步诊断为慢性肝功能衰竭急性发作(腹水、黄疸、凝血功能障碍和肝性脑病)并发感染性休克和多器官功能衰竭而入住重症监护病房(ICU)。肝炎检测(甲型肝炎IgM、乙型肝炎表面抗原、抗丙型肝炎抗体)和人类免疫缺陷病毒(HIV)筛查均为阴性。尽管采取了积极的支持措施,但患者病情仍恶化,在入住ICU的第4天死亡。已获得患者亲属的知情同意。

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