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[两例急性髓性白血病合并蜡样芽孢杆菌菌血症导致致命性颅内出血]

[Two cases of acute myelogenous leukemia with Bacillus cereus bacteremia resulting in fatal intracranial hemorrhage].

作者信息

Yoshida H, Moriyama Y, Tatekawa T, Tominaga N, Teshima H, Hiraoka A, Masaoka T, Yoshinaga T

机构信息

5th Department of Internal Medicine, Center For Adult Diseases, Osaka.

出版信息

Rinsho Ketsueki. 1993 Dec;34(12):1568-72.

PMID:8295331
Abstract

This manuscript reports Bacillus cereus sepsis in two cases with acute myelogenous leukemia (AML) who suffered complications of fatal intracranial hemorrhage during remission induction therapy. The first case was 43-year-old male with AML (M0) receiving first consolidation chemotherapy who developed sudden diarrhea, abdominal pain and spiking fever. Two days later, he died of intracranial hemorrhage. The second case was 15-year-old male with AML (M5b) who was receiving first induction chemotherapy. He developed headache and vomiting following spiking fever and diarrhea. He died of subarachnoid hemorrhage the next day. In both cases, Bacillus cereus was isolated from blood culture. Fatal intracranial hemorrhage due to severe bleeding tendency caused rapid to death in both cases. These bleeding tendencies might have been induced by B. cereus sepsis. In addition, we should not overlook B. cereus as contamination, but rather consider it as a potential pathogen, when isolated from blood culture.

摘要

本文报告了两例急性髓系白血病(AML)患者发生蜡样芽孢杆菌败血症的病例,这两名患者在缓解诱导治疗期间出现了致命性颅内出血并发症。第一例是一名43岁的AML(M0)男性患者,正在接受首次巩固化疗,出现了突发腹泻、腹痛和高热。两天后,他死于颅内出血。第二例是一名15岁的AML(M5b)男性患者,正在接受首次诱导化疗。他在高热和腹泻后出现头痛和呕吐。第二天,他死于蛛网膜下腔出血。在这两例病例中,血培养均分离出蜡样芽孢杆菌。由于严重的出血倾向导致的致命性颅内出血在两例病例中均迅速导致死亡。这些出血倾向可能是由蜡样芽孢杆菌败血症引起的。此外,当从血培养中分离出蜡样芽孢杆菌时,我们不应将其视为污染而忽视,而应将其视为潜在病原体。

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