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題名 | Masking the Diagnosis of Melioidosis in Initial Response to Penicillin--A Case Report from Mid-Taiwan=對青黴素治療有初始反應之類鼻疽--一中臺灣之病例報告 |
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作者 | 邱國樑; 夏德椿; 杭良文; 楊蓴; | 書刊名 | 胸腔醫學 |
卷期 | 16:3 2001.09[民90.09] |
頁次 | 頁179-182 |
分類號 | 415.4 |
關鍵詞 | 類鼻疽; 社區感染性肺炎; 敗血病; Melioidosis; Burkholderia pseudomallei; Community-acquired pneumonia; Septicemia; |
語文 | 英文(English) |
中文摘要 | 類鼻疽是一由Burkholderia pseudomallei所引起之感染,在臺灣並不常見。過去一直被認為是境外感染之疾病,但最近已有本土病例之文獻報告。類鼻疽常發生於熱帶地區,特別是東南亞如泰國、越南、緬甸等,並且有很高的死亡率。糖尿病是一個重要的危險因子。本文中,我們報告一個病例,一位78歲男性導遊,患有糖尿病,因社區性肺炎而住院。初始以靜脈青徽素治療獲得改善,出院後第二天又因再度發燒而住院。血液培養發現有Burkholderia pseudomallei。經以第三代抗生素ceftazidime治療三週後出院,並於門診持續以amoxicillin-clavulanic acid口服治療20週後痊癒。此為中臺灣第一個報告之病例,有海外旅遊中,並對青黴素治療有改善而後復發。故我們提出病例,用以再次強調旅遊史之重要性,及其對青黴素之初始反應造成診斷及治療之延誤有所警戒。 |
英文摘要 | Melioidosis is an infection caused by Burkholderia pseudomallei (B. pseudomallei), and is a rare disease in Taiwan. It was thought to be an imported disease, mainly from Southeast Asia, but recently, there have been some indigenous cases reported in Taiwan. A 78 year-old gentleman, who was admitted due to community-acquired pneumonia, had an initially good response to parenteral penicillin, and was discharged in 7 days. Recurrent episodes of fever developed 2 days after discharge. Burkholderia pseudomallei septicemia was then noticed during the second hospitalization. The fever subsided 3 days after treatment with ceftazidime. Based on this cases, we concluded that community-acquired pneumonia with an initial response to penicillin therapy could be a presentation of melioidosis, and might delay the actual diagnosis and treatment. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。