由于Actinomyces Odontolyticus与胃肠外体相关的肝的细菌病
Van Duyet Nguyen1, Viet Nghia Le1,2, Quoc Phuong Nguyen1
1Infectious Department, Hanoi Medical University, Hanoi, Vietnam.
European journal of case reports in internal medicine
|December 11, 2025
概括
这一案例突出了一个罕见的肝病例,由Actinomyces odontolyticus引起,与穿孔的鱼骨相关. 通过CT扫描及时诊断和联合治疗对于管理如此复杂的肝脏动因菌病病例至关重要.
科学领域:
- 医学 医学 医学 医学 医学
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 肝性动因菌症是一种罕见的腹内感染,通常是由Actinomyces odontolyticus引起的.
- 由穿孔胃肠外体引起的肝非常罕见.
- 这份报告详细介绍了第一起因A. odontolyticus与鱼骨外体相关的细菌病和肝的记录病例.
研究的目的:
- 报告一个独特的肝脏和由Actinomyces odontolyticus引起的细菌病例.
- 为了强调诊断挑战和肝脏动因子二次性胃肠外体的管理.
- 强调先进成像和综合治疗策略的重要性.
主要方法:
- 一个病例报告,一名86岁的痴呆症男性出现了发烧和右上象限腹部疼痛.
- 诊断程序包括腹部超声波,血液和液培养 (通过MALDI-TOF MS识别了A. odontolyticus),以及对比度增强的计算机断层扫描 (CT) 扫描.
- 治疗包括穿皮排水,腹腔镜手术以移除异物体,以及长时间的抗生素治疗 (皮帕西林/塔扎巴克坦,其次是阿莫西林/克拉夫兰酸盐).
主要成果:
- 确定了一种肝脏,培养证实了Actinomyces odontolyticus.
- 通过CT扫描发现一种从十二指肠透到肝脏的鱼骨异物体.
- 患者在外体的外科切除,液排水和抗生素治疗后成功康复.
结论:
- 增强对比度的CT扫描对于诊断肝脏不响应常规治疗至关重要,特别是在老年痴呆患者中.
- 在不清楚病因的肝的差异诊断中,应考虑Actinomyces物种.
- 成功管理需要多模式的方法,包括异物清除,液排水和延长的抗生素治疗.
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