姐弟先后患紫色色桿菌膿毒血癥
發(fā)布時(shí)間：2018-09-19 12:33
【摘要】：報(bào)告2例姐弟先后患紫色色桿菌膿毒血癥。例1.患兒女(姐姐),6歲。皮膚科檢查:左乆窩下一4 cm×2 cm不規(guī)則潰瘍面,表面可見(jiàn)黃色膿性分泌物和新生肉芽腫,周圍腫脹。實(shí)驗(yàn)室及輔助檢查:血常規(guī)中WBC 15.36×109/L,白細(xì)胞分類:N0.75,血涂片示中性粒細(xì)胞增多伴中毒性改變。分泌物及淋巴結(jié)穿刺液細(xì)菌培養(yǎng)示紫色色桿菌生長(zhǎng)。彩超示多發(fā)性肝、脾膿腫。診斷:紫色色桿菌膿毒血癥、多臟器膿腫。治療:予靜脈滴注頭孢哌酮/舒巴坦(1.5 g,每日2次)抗感染,29 d后出現(xiàn)高熱伴驚厥、腹痛及咳嗽,多臟器膿腫救治無(wú)效死亡。例2.患兒男(弟弟),5歲。皮膚科檢查:雙下肢散在分布數(shù)個(gè)大小不等暗紅色肉芽腫樣結(jié)節(jié)伴小膿皰,部分形成潰瘍,周圍有炎性浸潤(rùn)性紅暈,雙側(cè)腹股溝觸及增大的淋巴結(jié)伴壓痛。實(shí)驗(yàn)室及輔助檢查:血常規(guī)中WBC 29.39×109/L,N 0.86;降鈣素原6.48μg/L,分泌物細(xì)菌培養(yǎng)示紫色色桿菌生長(zhǎng)。診斷:紫色色桿菌膿毒血癥。治療:予靜脈滴注亞胺培南(0.5 g,每日2次)和頭孢哌酮/舒巴坦(1.5 g,每日2次),補(bǔ)液及對(duì)癥支持,治療20 d后患者雙下肢潰瘍結(jié)痂完全脫落,各項(xiàng)實(shí)驗(yàn)室檢查均恢復(fù)正常。隨訪2年,病情無(wú)復(fù)發(fā)。
[Abstract]:Two cases of sepsis of chromobacterium purpura were reported. Example 1. The girl (sister) was 6 years old. Dermatology examination: left side of 4 cm 脳 2 cm irregular ulcer surface under the nest, yellow purulent secretion and new granuloma on the surface, swelling around. Laboratory and auxiliary examination: WBC 15.36 脳 10 9 / L in blood routine, WBC classification: n 0.75, blood smear showed neutropenia with toxic changes. Bacterial culture in secretion and lymph node puncture fluid showed the growth of chromobacterium purpura. Color Doppler ultrasound showed multiple liver and spleen abscess. Diagnosis: chromobacterium purpura sepsis, multiple organ abscess. Treatment: after intravenous cefoperazone / sulbactam (1.5 g, twice a day), fever with convulsion, abdominal pain and cough occurred 29 days later, and multiple organ abscess failed to cure death. Example 2. The boy (younger brother) was 5 years old. Dermatology examination: several dark red granulomatous nodules with small pustules were scattered in the lower extremities, with ulcers, inflammatory infiltrating red halo around, bilateral inguinal lymph nodes with tenderness. Laboratory and auxiliary examination: WBC 29.39 脳 10 9 / L N 0.86, procalcitonin 6.48 渭 g / L, secretion bacteria culture showed the growth of chromobacterium purple. Diagnosis: chromobacterium purpura sepsis. Treatment: intravenous drip of imipenem (0.5 g, twice a day) and cefoperazone / sulbactam (1.5 g, twice a day), fluid resuscitation and symptomatic support. After 20 days of treatment, the crusts of both lower extremity ulcers were completely scabbed off, and all laboratory examinations returned to normal. Follow-up for 2 years showed no recurrence.
【作者單位】： 贛南醫(yī)學(xué)院第一附屬醫(yī)院皮膚科;贛南醫(yī)學(xué)院護(hù)理學(xué)院;
【分類號(hào)】：R720.597
本文編號(hào)：2250129
[Abstract]:Two cases of sepsis of chromobacterium purpura were reported. Example 1. The girl (sister) was 6 years old. Dermatology examination: left side of 4 cm 脳 2 cm irregular ulcer surface under the nest, yellow purulent secretion and new granuloma on the surface, swelling around. Laboratory and auxiliary examination: WBC 15.36 脳 10 9 / L in blood routine, WBC classification: n 0.75, blood smear showed neutropenia with toxic changes. Bacterial culture in secretion and lymph node puncture fluid showed the growth of chromobacterium purpura. Color Doppler ultrasound showed multiple liver and spleen abscess. Diagnosis: chromobacterium purpura sepsis, multiple organ abscess. Treatment: after intravenous cefoperazone / sulbactam (1.5 g, twice a day), fever with convulsion, abdominal pain and cough occurred 29 days later, and multiple organ abscess failed to cure death. Example 2. The boy (younger brother) was 5 years old. Dermatology examination: several dark red granulomatous nodules with small pustules were scattered in the lower extremities, with ulcers, inflammatory infiltrating red halo around, bilateral inguinal lymph nodes with tenderness. Laboratory and auxiliary examination: WBC 29.39 脳 10 9 / L N 0.86, procalcitonin 6.48 渭 g / L, secretion bacteria culture showed the growth of chromobacterium purple. Diagnosis: chromobacterium purpura sepsis. Treatment: intravenous drip of imipenem (0.5 g, twice a day) and cefoperazone / sulbactam (1.5 g, twice a day), fluid resuscitation and symptomatic support. After 20 days of treatment, the crusts of both lower extremity ulcers were completely scabbed off, and all laboratory examinations returned to normal. Follow-up for 2 years showed no recurrence.
【作者單位】： 贛南醫(yī)學(xué)院第一附屬醫(yī)院皮膚科;贛南醫(yī)學(xué)院護(hù)理學(xué)院;
【分類號(hào)】：R720.597
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