阴性尿培养的诊断挑战
Chisato Nakajima1, Masahiro Kashiura1, Shiho Togo1
1Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, JPN.
Cureus
|August 20, 2025
概括
由于其无氧性,Clostridium perfringens是一种罕见的尿路感染原因,可能会带来挑战. 这一案例突显了它在医疗相关感染中的潜在作用,
科学领域:
- 传染性疾病
- 微生物学
- 尿道病学
背景情况:
- 杆菌是尿路感染 (UTI) 的不常见原因.
- 无氧细菌在临床微生物学中构成诊断挑战.
- 在脆弱患者群体中,与医疗保健相关的尿路感染是一个重大问题.
研究的目的:
- 报告一个罕见的Clostridium perfringens导致严重的尿路感染.
- 强调与无氧性尿路感染相关的诊断挑战和临床线索.
- 强调在高风险患者中考虑厌氧病原体的重要性.
主要方法:
- 一位59岁的女性患有糖尿病和子宫癌.
- 临床表现:发烧,呼吸困难,腰椎角疼痛,阴红色的尿液.
- 诊断工作:尿液分析,格拉姆染色,CT扫描,血液和尿液培养.
主要成果:
- 血液培养对Clostridium perfringens呈阳性;尿液培养呈阴性.
- 图像显示骨中的气体.
- 患者经历了血液溶解,功能障碍和循环崩.
- 在抗菌疗法和支架更换后稳定.
结论:
- 在免疫功能低下的患者中,Clostridium perfringens可引起与医疗相关的严重尿路感染.
- 阴性尿培养需要无氧培养技术来检测可疑的尿道感染.
- 血管内血溶和骨中的气体是关键的诊断指标.
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