发烧性复发性细胞质炎因老年患者在线索利德诱导的乳酸化症而复杂化
Yanizbeth Yambó-Chévere1, Rafael Bermúdez-Rivera1,2
1Department of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico.
The American journal of case reports
|December 22, 2025
概括
这一案例凸显了老年人细胞炎诊断的挑战,这些老年人可能不表现出典型的发烧或高白细胞计数. 长时间使用线索利德可以导致乳酸,强调老年患者的仔细监测.
科学领域:
- 老年医学 老年医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 蜂炎通常伴有发烧和白细胞病变,但这些症状可以在老年人中减弱,原因是免疫衰老和并发症.
- 莱涅佐利德对耐药性格拉姆阳性细菌有效,但随着长时间使用,会带来线粒体毒性和乳酸的风险.
研究的目的:
- 报告老年患者复发性细胞炎的病例,该病例患有多种并发症.
- 突出在脆弱的老年人中表现的非典型细胞质炎的诊断挑战.
- 为了强调在延长治疗期间因线索利德诱导的乳酸酸的风险.
主要方法:
- 一个87岁的妇女病例报告,患有复发性纤维炎和多种并发症.
- 对临床表现,实验室发现 (CRP和ESR升高),伤口培养 (多微生物) 和抗生素治疗 (包括线索利德) 的审查.
- 监测和肝功能,并进行超声波成像,以排除或骨髓炎.
主要成果:
- 患者出现了炎症,但仍然没有发烧,没有白细胞病.
- 伤口培养揭示了多微生物生物,包括Pseudomonas aeruginosa.
- 患者在大约8周的累积线索利德暴露后发展出乳酸,这表明线粒体毒性.
结论:
- 在脆弱的老年人中,发烧性纤维炎带来了诊断挑战.
- 警线索利德诱导的乳酸性酸症至关重要,特别是在非典型的表现和延长治疗期间.
- 综合老年护理,生物标志物监测和抗菌药物管理对于改善弱势老年患者的治疗结果至关重要.
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