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迈耶放线菌引起的播散性感染:病例报告及文献复习

Disseminated infection due to Actinomyces meyeri: case report and review.

作者信息

Apothéloz C, Regamey C

机构信息

Service de Médecine, Hôpital Cantonal, Fribourg, Switzerland.

出版信息

Clin Infect Dis. 1996 Apr;22(4):621-5. doi: 10.1093/clinids/22.4.621.

Abstract

Actinomyces meyeri is rarely isolated in cases of actinomycosis. We present a case of disseminated actinomycosis due to A. meyeri; the patient had an abscess of the lung, osteomyelitis of the tibia, and multiple skin abscesses. Cure was achieved with surgical debridement and administration of intravenous penicillin, followed by oral penicillin, for 1 year. A concomitant gram-negative bacillus, Actinobacillus actinomycetemcomitans, was also isolated. Review of the literature revealed only 26 well-documented cases of infection with A. meyeri. Male adults are mainly affected, and alcoholism is frequently the underlying condition in these patients. Associated bacteria were isolated in two-thirds of these cases. In contrast to other species of Actinomyces, A. meyeri often causes pulmonary infection and shows a tendency for hematogenous dissemination. Even though multiple organs are involved, the outcome for these patients is excellent when penicillin is administered for several months and surgical procedures are performed when necessary.

摘要

迈耶放线菌在放线菌病病例中很少分离得到。我们报告一例由迈耶放线菌引起的播散性放线菌病病例;该患者有肺脓肿、胫骨骨髓炎和多处皮肤脓肿。通过手术清创并静脉注射青霉素,随后口服青霉素治疗1年,治愈了该患者。同时还分离出一种革兰氏阴性杆菌——伴放线放线杆菌。文献回顾显示,仅有26例记录良好的迈耶放线菌感染病例。主要受影响的是成年男性,酗酒常常是这些患者的潜在病因。在这些病例中,三分之二分离出了相关细菌。与其他放线菌属物种不同,迈耶放线菌常引起肺部感染,并显示出血行播散的倾向。尽管多个器官受累,但当给予患者数月青霉素治疗并在必要时进行外科手术时,这些患者的预后良好。

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