一个社区获得的Clostridioides difficile感染病例导致肠,严重的肺炎和严重的低血
Yoshiaki Iwashita1, Shizue Takeuchi2, Yoshiro Hadano3
1Department of Emergency and Critical Care Medicine, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan. iwaci1ta@med.shimane-u.ac.jp.
BMC infectious diseases
|July 28, 2024
概括
一个罕见的成年人内受精病例是由社区获得的Clostridioides difficile感染引起的,导致严重的并发症. 这凸显了在诊断严重肠炎时需要考虑C. difficile的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 困难菌感染 (CDI) 通常与抗生素使用有关,并导致腹.
- 报告指出,新出现的双重产生毒素的C. difficile引起 fulminant腹的病例是独立于抗生素的.
- 成人内肠是罕见的,只有少数记录的病例与C. difficile有关.
研究的目的:
- 报告一个单一的成年人肠道静脉分泌病例,这是社区获得的C. difficile感染的次要原因.
- 为了研究所涉及的C. difficile菌株的特征.
- 强调在诊断严重肠炎时考虑C. difficile的重要性.
主要方法:
- 一个82岁的男性患有严重的低血,肺炎和败血性休克的病例介绍.
- 诊断成像显示上升的结肠内;结肠镜排除了恶性病变.
- 鉴定社区获得的C. difficile感染,使用万科米治疗,以及随后的手术干预.
主要成果:
- 该患者出现了严重的低血,肺炎和败血症休克,并由内肠接复杂化.
- 困难菌株 (SUH1) 是二元产生毒素的菌株,属于新型序列类型 (ST1105) 和第3类,表明高毒性.
- 最初的万科米辛治疗失败了,但手术干预导致了临床改善.
结论:
- 二元产生毒素的C.difficile可以在成年人中引起内.
- 在严重肠炎的差异诊断中,即使在日本,也应该考虑社区获得的C. difficile.
- 这一案例强调了C. difficile感染的多样化和严重的临床表现.
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