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頁籤選單縮合
題名 | 肺類鼻疽合併敗血症--病例報告=Pulmonary Melioidosis Complicated with Sepsis--A Case Report |
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作者 | 賴秉廉; 班仁知; 項正川; | 書刊名 | 安泰醫護雜誌 |
卷期 | 17:1 2011.03[民100.03] |
頁次 | 頁55-62 |
分類號 | 415.15 |
關鍵詞 | 類鼻疽; 類鼻疽伯克氏菌; 敗血症; 肺炎; 糖尿病; Melioidosis; Burkholderia pseudomallei; Sepsis; Pneumonia; Diabetes mellitus; |
語文 | 中文(Chinese) |
中文摘要 | 類鼻疽的致病菌為類鼻疽伯克氏菌(Burkholderia pseudomallei),人類因直接接觸、吸入和食入病源菌而感染。類鼻疽為伺機性感染,病症表現從急性到慢性,從局部到全身性,都有可能,若併發敗血性休克,則死亡率更是超過八成。此菌感染最重要的危險因子包含糖尿病、酗酒和慢性腎臟病。對於類鼻疽,及早且正確的抗生素治療,可有效降低死亡率,整體抗生素治療時間需達至少十二週以上,病人服藥順從性對於治療是否成功有著巨大的影響。本病例為一46歲女性,因家中水患,協助清理家園,六日後發生高燒、頭痛、乾咳等現象。前往本院急診,最初臆斷為左上葉肺炎收入院治療。住院後診斷出有糖尿病且合併酮酸中毒,血液培養報告證實為類鼻疽伯克氏菌感染,經適當治療後,病人病情改善,出院後持續給予口服抗生素治療。 |
英文摘要 | The pathogen of melioidosis is Burkholderia pseudomallei. Humans are infected by direct contact, inhalation, or ingestion of the pathogen. Melioidosis is an opportunistic infection, and patients experience a variety of symptoms in either localized areas or the whole body, including acute and chronic diseases. The mortality rate is more than 80% if melioidosis complicated with septic shock. The most important risk factors for melioidosis are diabetes, excessive alcohol ingestion, and chronic renal disease. Early and accurate antibiotic treatment for melioidosis contributes to the lower the mortality rate. The whole course of antibiotic treatment should be required for more than 12 weeks and the compliance of the patient is very important for successful treatment. This case report reveals a 46 year-old woman who had cleaned up her house after floods presented with high fever, headache and dry cough. She visited our emergency room and then admission was arranged under the tentative diagnosis of pneumonia, left upper lobe. Right after she was admitted to our hospital, diabetes mellitus with diabetic ketoacidosis was diagnosed. In addition, Burkholderia pseudomallei grew in the blood culture a few days after admission. Her condition improved through a series of adequate treatments. Then she was discharged and eradication therapy with oral antibiotics was maintained. |
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