Roca B, Vilar C, Pérez E V, Sáez-Royuela A, Simón E
Infectious Diseases Unit, Hospital General, Castellón, Spain.
Presse Med. 1996 May 18;25(17):803-4.
The incidence of Pseudomonas aeruginosa in HIV-infected patients has increased over the last years. We describe a case of pseudomonal breast abscess complicated with fatal septicemia in an AIDS patient.
A 21-year-old woman was admitted for fever, chills, nausea, vomiting and pain in the breast. She had a swelling in the right breast of 3 days duration. HIV infection had been confirmed 6 years earlier. CD4 count was 2/mm3. Surgical drainage produced a blue-green purulent discharge which grew Pseudomonas aeruginosa on culture. Despite cloxacilin, then ceftazidime and amikacin, initial improvement was followed 2 weeks later by nodular pulmonary infiltration with cavitation. P. aeruginosa was recovered from sputum and blood cultures, but stepwise resistance developed and the patient died 3 months after admission.
Breast abscesses are infrequent in nonlactating women. P. aeruginosa is rarely involved, even in HIV patients. Due to the risk of resistance, prompt administration of appropriate antibiotics is required.
在过去几年中，艾滋病毒感染患者铜绿假单胞菌的发病率有所上升。我们描述了一例艾滋病患者发生假单胞菌性乳腺脓肿并发致命性败血症的病例。
一名21岁女性因发热、寒战、恶心、呕吐及乳房疼痛入院。她右侧乳房肿胀已有3天。6年前确诊感染艾滋病毒。CD4细胞计数为2/mm³。手术引流引出蓝绿色脓性分泌物，培养显示为铜绿假单胞菌。尽管最初使用了氯唑西林，随后使用了头孢他啶和阿米卡星，但最初病情有所改善，2周后出现结节性肺浸润并伴有空洞形成。痰培养和血培养均检出铜绿假单胞菌，但逐步出现耐药，患者入院3个月后死亡。
非哺乳期女性乳腺脓肿并不常见。铜绿假单胞菌很少涉及，即使在艾滋病毒患者中也是如此。由于存在耐药风险，需要及时给予适当的抗生素。
