Wiesenfeld H C, Berg S R, Sweet R L
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania.
Obstet Gynecol. 1994 May;83(5 Pt 2):887-9.
Serious infections caused by Torulopsis glabrata, once rarely encountered, have become common over the last 3 decades. The most frequent manifestations of serious fungal infections include septicemia, endocarditis, hepatosplenic infections, and meningitis. We report a case of fungemia and pelvic abscess caused by T glabrata following gynecologic surgery.
A 43-year-old woman developed fever, abdominal pain, and abdominal distention following a total abdominal hysterectomy and right salpingo-oophorectomy. Empirical treatment with broad-spectrum antimicrobial agents was not successful. Three sets of blood cultures were positive for T glabrata, and radiologic investigations revealed pelvic and lesser sac fluid collections. Cultures of the pelvic abscess grew T glabrata. Treatment was changed to amphotericin B, with complete clinical recovery.
Serious T glabrata infections are rare following gynecologic surgery, especially in immunocompetent patients. Given the morbidity and mortality associated with these infections, aggressive treatment with amphotericin B and drainage of abscesses is warranted.
光滑念珠菌引起的严重感染曾较为罕见,但在过去30年中已变得常见。严重真菌感染最常见的表现包括败血症、心内膜炎、肝脾感染和脑膜炎。我们报告1例妇科手术后由光滑念珠菌引起的真菌血症和盆腔脓肿病例。
1例43岁女性在全腹子宫切除术和右侧输卵管卵巢切除术后出现发热、腹痛和腹胀。经验性使用广谱抗菌药物治疗无效。3份血培养结果显示光滑念珠菌阳性,影像学检查发现盆腔和网膜囊有积液。盆腔脓肿培养出光滑念珠菌。治疗改为两性霉素B,患者临床完全康复。
妇科手术后严重的光滑念珠菌感染罕见,尤其是在免疫功能正常的患者中。鉴于这些感染相关的发病率和死亡率,有必要积极使用两性霉素B治疗并引流脓肿。