在切除术20年后,由大肠杆菌引起的压倒性的脊髓切除术后感染:一个病例报告
Yoshinobu Abe1, Hideya Itagaki1, Tomoyuki Endo1
1Division of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University, Sendai, JPN.
Cureus
|August 21, 2023
概括
压倒性的脊髓切除术后感染 (OPSI) 是一种罕见但致命的并发症. 这一案例突出显示了在脊髓切除术后的患者中由大肠杆菌引起的致命OPSI,强调了高度临床怀疑的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 脊髓切除术后的患者面临严重感染的风险增加,包括压倒性的脊髓切除术后感染 (OPSI).
- 虽然OPSI并不常见,但其死亡率很高,通常与封装细菌有关.
研究的目的:
- 报告由大肠杆菌引起的OPSI致命病例,该病例发生在一位老年患者身上,该患者有脊髓切除术史和最近使用类固醇.
- 强调在切除术患者中识别OPSI的重要性,即使有非典型的病原体.
主要方法:
- 一个80岁的男性病人的病例报告,呈现出败血症休克和紫色.
- 审查患者的病史,包括脊髓切除术和涉嫌IgG4相关疾病的普得尼索隆治疗.
主要成果:
- 这位患者几十年前曾经做过脊髓切除术,患上了白内障炎,并由败血症休克和紫色满症复杂化.
- 确定的致病原体是大肠杆菌,这是OPSI的非典型病原体,突出显示了脊髓切除术后患者的细菌清除受损.
结论:
- 医生必须保持高的OPSI怀疑指数,在脊髓切除术后出现严重败血症的患者中,无论病因如何.
- 在脊髓切除术后,告知患者严重的,可能致命的感染风险对于主动管理至关重要.
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