尿路感染后感染性内心炎的一个病例是Proteusmirabilis
Kohei Maruyama1, Naoya Harada2, Hiroki Katsumata3
1Division of Antimicrobial Stewardship Program, Japan; Department of Pharmacy, Japan.
概括
本病例报告详细介绍了一种罕见的传染性内心炎 (IE) 病例,该病例是由gram阴性杆菌Proteus mirabilis引起的. 该研究强调了心声回声学在诊断IE中的重要性,特别是当伴随着脑血管事件时.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 传染性内心炎 (IE) 通常是由菌引起的.
- 由于格拉姆阴性杆菌的IE,例如Proteus mirabilis,很少见,全球报告的病例很少.
- 奇迹蛋白更常见地与尿路感染有关.
研究的目的:
- 在老年患者中报告一种由Proteus mirabilis引起的IE罕见病例.
- 强调心声回声学在患有P. mirabilis细菌病和脑血管事件的患者的诊断作用.
- 讨论在这种罕见情况下的管理挑战和治疗结果.
主要方法:
- 一个93岁的女性患者的病例报告.
- 临床表现包括肺炎,功能障碍和意识变化.
- 诊断工作包括血液和尿液培养,头骨成像和胸前心脏回声学.
- 对抗菌素敏感性测试和逐步调整抗生素治疗.
- 没有手术干预的临床过程评估.
主要成果:
- 这位患者出现了P.奇迹性细菌病,结石性炎症,功能障碍和多次脑梗塞.
- 胸外心声扫描揭示了 mitra 门上的移动植被,从而诊断出可能的 IE.
- 尽管进行了适当的抗生素治疗,但发生了植被扩大和新的脑梗塞,表明治疗失败.
- 患者的晚年和病情排除了手术干预的可能性.
结论:
- 这一案例说明了一个罕见的IE病例,由Proteus mirabilis引起,源于尿路感染.
- 心声学对于诊断患有P. mirabilis bacteremia的患者的IE至关重要,特别是当神经复杂症存在时.
- 在这种情况下,治疗失败凸显了老年患者多种并发病的IE管理的复杂性.
相关概念视频
01:25Endocarditis I: Introduction
648
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
648
01:25Urinary Tract Infection II: Pathophysiology
980
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
980
01:26Urinary Tract Infection I: Introduction
895
Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
895
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
380
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
380
01:18Endocarditis III: Medical Management
296
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
296
01:29Endocarditis IV: Nursing Management
513
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
513