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題名 | Persistent Fever and Left Pleural Effusion Due to Occult Splenic Abscess in a Diabetic Patient on Long-Term Hemodailysis=長期血液透析病人之隱匿性脾膿腫引起持續發燒 |
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作者 | 鄭彩梅; 盧國城; 鄭景泉; 楊麗瓊; 陳應盛; 冉祥俊; 呂福江; 陳嘉美; 曾金鳳; Zheng, Cai-mei; Lu, Kuo-cheng; Zheng, Jing-quan; Yang, Li-king; Chen, Yin-sheng; Jan, Hsiang-chun; Leu, Fur-jiang; Chen, Chia-mei; Tseng, Chin-feng; |
期刊 | 臺灣腎臟醫學會雜誌 |
出版日期 | 20100300 |
卷期 | 24:1 2010.03[民99.03] |
頁次 | 頁47-52 |
分類號 | 415.816 |
語文 | eng |
關鍵詞 | 不明原因發燒; 脾膿瘍; 糖尿病; 血液透析; Fever of unknown origin; Splenic abscess; Diabetes mellitus; Hemodailysis; |
中文摘要 | 長期接受血液透析的病人最常見的罹病和死亡的原因為感染,尤其有糖尿病的患者發生率更高,而發燒是感染症最常見的臨床表現。無論是一般人或是接受洗血液透析的病人,脾膿腫是一種少見的敗血症感染來源,而且如果不及早診治,可能危及生命。我們報告一例糖尿病合併末期腎病患者接受長期血液透析治療,因為不明原因的發燒而住院,經診斷為中耳炎接受靜脈抗生素治療,但因高燒不退,且左胸腔出現積液,最後被診斷為隱匿性脾膿腫。細菌培養結果為罕見之黏質沙雷氏菌(Serratia marcescens),病患接受手術及抗生素治療得以痊癒。 |
英文摘要 | Splenic abscess is relatively rare and may he easily missed. It is mostly replace with commonly encountered in immunocompromised patients, such as patients with end-stage renal disease (ESRD) on long-term dialysis, particularly those with concomitant diabetes. In these patients, occult infections may have non-specific and atypical presentations. Patients usually present with unexplained fever and are susceptible to infection by unusual organisms which might cause delays in diagnosis and treatment. We present a diabetic patient with ESRD on long-term hemodialysis who developed persistent fever and left pleural effusion. He was eventually found to have splenic abscess due to an unusual pathogen, Serratia marcescens. |
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