Wei Hong, Xu Lifan, Li Lu, Shen Yong, Yu Sijie, Huang Haiyan, Huang Xin
Department of Emergency Medicine, Affiliated Lu'an Hospital of Anhui Medical University, Lu'an, Anhui, 237005, People's Republic of China.
Department of Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, 230001, People's Republic of China.
Infect Drug Resist. 2025 Sep 4;18:4723-4730. doi: 10.2147/IDR.S546360. eCollection 2025.
Hypervirulent is a recently identified pathotype characterized by high virulence and rapid dissemination. It is associated with invasive infections at multiple anatomical sites, including liver abscesses, necrotizing fasciitis, meningitis, myositis, and endophthalmitis. It has emerged as a significant threat to public health due to its aggressive clinical course and high mortality rate. This case presents a 63-year-old female diabetic patient who developed lung abscess, liver abscess, and bacterial meningitis. Typical clinical manifestations confirmed through imaging, microbiological culture analysis, and whole-genome sequencing (ST65-K1) revealed Hypervirulent infection. The patient was comatose with purulent cerebrospinal fluid and obstructed drainage. Such severe cases of Hypervirulent intracranial infection are extremely rare. Early cerebrospinal fluid exchange, combined with intrathecal amikacin injection, was initiated. After one month of active treatment, the patient exhibited improved clinical outcomes and was subsequently discharged. This case highlights that patients with diabetes, particularly those presenting with high-risk comorbidities, are predisposed to developing triggering factors for invasive syndrome invasive syndrome. Early identification and implementation of individualized cerebrospinal fluid exchange therapy combined with intrathecal antibiotic therapy in critically ill meningitis patients infected with invasive syndrome are pivotal for improving prognosis. Collectively, these findings provide novel insights and a valuable framework for developing future therapeutically efficacious strategies for the management of Hypervirulent . However, this regimen does not standard-of-care, and further evidence is required to establish its safety and clinical effectiveness.
高毒力型是最近发现的一种致病类型，其特点是毒力高且传播迅速。它与多个解剖部位的侵袭性感染有关，包括肝脓肿、坏死性筋膜炎、脑膜炎、肌炎和眼内炎。由于其侵袭性的临床病程和高死亡率，它已成为对公共卫生的重大威胁。本病例介绍了一名63岁的女性糖尿病患者，她出现了肺脓肿、肝脓肿和细菌性脑膜炎。通过影像学、微生物培养分析和全基因组测序（ST65-K1）确认的典型临床表现显示为高毒力型感染。患者昏迷，伴有脓性脑脊液且引流受阻。这种高毒力型颅内感染的严重病例极为罕见。开始进行早期脑脊液置换，并联合鞘内注射阿米卡星。经过一个月的积极治疗，患者的临床结局有所改善，随后出院。该病例强调，糖尿病患者，尤其是那些伴有高危合并症的患者，易发生侵袭性综合征的触发因素。对于感染侵袭性综合征的重症脑膜炎患者，早期识别并实施个体化的脑脊液置换疗法联合鞘内抗生素治疗对于改善预后至关重要。总体而言，这些发现为制定未来治疗高毒力型感染有效策略提供了新的见解和有价值的框架。然而，这种治疗方案并非标准治疗方法，需要进一步的证据来确定其安全性和临床有效性。
