Ioannidis J P, Worthington M, Griffiths J K, Snydman D R
Department of Medicine, New England Medical Center Hospitals, Boston, Massachusetts 02111, USA.
Clin Infect Dis. 1995 Aug;21(2):390-7. doi: 10.1093/clinids/21.2.390.
Fifty-eight cases of bacteremia due to Moraxella catarrhalis, including seven that occurred in patients treated at our facilities, are analyzed. The host's medical history plays a major role in the presentation and outcome of M. catarrhalis bacteremia. Bacteremia is typically accompanied by pneumonia in adults with underlying respiratory disease. Many neutropenic patients do not manifest a focus of infection; in contrast, the source identified in healthy, immunocompetent patients is usually the upper airway or the ears. In the recent literature, it has been reported that a rash is typically absent in adults with bacteremic pneumonia and in immunocompetent hosts and that only some neutropenic patients have a rash. The prognosis is grave for patients with endocarditis and for patients with immunoglobulin deficiency or neutropenia not related to a hematologic malignancy. In addition, mortality is substantial among bacteremic patients with respiratory conditions or other chronic debilities, especially when respiratory copathogens are present. The prognosis is good for febrile neutropenic patients with underlying leukemia or lymphoma when the neutropenia resolves. When healthy, immunocompetent individuals are affected with M. catarrhalis bacteremia, their presentations range from self-limited febrile illness to life-threatening disease.
分析了58例由卡他莫拉菌引起的菌血症病例，其中7例发生在我们机构接受治疗的患者中。宿主的病史在卡他莫拉菌菌血症的表现和转归中起主要作用。菌血症在患有基础呼吸系统疾病的成人中通常伴有肺炎。许多中性粒细胞减少的患者没有感染灶；相比之下，在健康、免疫功能正常的患者中确定的感染源通常是上呼吸道或耳朵。在最近的文献中，有报道称菌血症性肺炎的成人和免疫功能正常的宿主通常没有皮疹，只有一些中性粒细胞减少的患者有皮疹。患有心内膜炎的患者以及患有与血液系统恶性肿瘤无关的免疫球蛋白缺乏症或中性粒细胞减少症的患者预后严重。此外，患有呼吸系统疾病或其他慢性衰弱疾病的菌血症患者死亡率很高，尤其是当存在呼吸道合并病原体时。当中性粒细胞减少症缓解时，患有基础白血病或淋巴瘤的发热性中性粒细胞减少患者预后良好。当健康、免疫功能正常的个体感染卡他莫拉菌菌血症时，其表现范围从自限性发热性疾病到危及生命的疾病。
