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[1例肺结核后遗症患者发生肠炎沙门菌所致脓胸]

[A case of empyema caused by Salmonella enteritidis in a patient with sequela of pulmonary tuberculosis].

作者信息

Suzuki H, Okamura T, Imamura A, Yuasa K, Iguchi M, Ieki R, Goto H, Moriyama H, Nishimura Y, Ikeda T, Saku K

机构信息

Department of Pulmonary Diseases, Tokyo Metropolitan Komagome General Hospital, Japan.

出版信息

Kansenshogaku Zasshi. 1996 Apr;70(4):382-5. doi: 10.11150/kansenshogakuzasshi1970.70.382.

Abstract

A 69-year-old male was admitted to our hospital on Jan. 10, 1995 complaining of bloody sputum, left back pain and fever of 39 degrees C. He had a history of pulmonary tuberculosis 45 years ago. His chest X-ray and CT showed the presence of air-fluid level in the left pleural cavity with thickening and calcification of the pleura. Salmonella Enteritidis was isolated from the sputum, bronchoalveolar lavage fluid and stool. He was diagnosed as suffering from Salmonella-empyema with an internal fistula. Based on the in vitro sensitivity test, sulfamethoxazole/trimethoprim was started. However, the efficacy of the antimicrobia was not sufficient. He then underwent left pleuropneumonectomy. Salmonella was cultured also from the specimen obtained at the operation. His course after operation was uneventful. Thus, although Salmonella Enteritidis is known as a common pathogen of food poisoning, it can cause empyema, especially in a case with an impaired host defence system.

摘要

一名69岁男性于1995年1月10日因咯血、左背痛及39摄氏度发热入住我院。他45年前有肺结核病史。胸部X线和CT显示左胸腔有气液平面,胸膜增厚并钙化。痰液、支气管肺泡灌洗液及粪便中分离出肠炎沙门氏菌。他被诊断为患有伴有内瘘的沙门氏菌性脓胸。根据体外药敏试验,开始使用磺胺甲恶唑/甲氧苄啶。然而,抗菌药物的疗效并不充分。随后他接受了左胸膜肺切除术。手术标本中也培养出了沙门氏菌。术后他恢复顺利。因此,尽管肠炎沙门氏菌是已知的食物中毒常见病原体,但它可引起脓胸,尤其是在宿主防御系统受损的情况下。

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