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題 名 | Vibrio Parahemolyticus Bacteremia: Case Report=腸炎弧菌菌血症:病例報告 |
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作 者 | 吳天聰; 江秉誠; 吳竹蘭; 呂學重; | 書刊名 | 長庚醫學 |
卷 期 | 22:3 1999.09[民88.09] |
頁 次 | 頁508-514 |
分類號 | 414.83 |
關鍵詞 | 腸炎弧菌; 菌血症; Vibrio parahemolyticus; Bacteremia; Septicemia; |
語 文 | 英文(English) |
中文摘要 | 腸炎弧菌(Vibrio parahemolyticus)是一種生活於海洋中的革蘭氏陰性弧狀細菌,是 目前造成台灣感染性急性腸胃炎的主要病源菌,其次可造成軟組織炎,但是極少造成菌血症。 以往在文獻上也只有11例報告而已。大多數的病人都有進食海產或接觸海水的病史,而且 所有的病人都有造成免疫機能不全的疾病,當中以白血病及肝硬化為最重要,在此我們要報 告1例60歲男性病患的病歷,病患本身患有慢性C型肝炎及腎上腺功能不全症,於發生腸 炎弧菌菌血症的前1星期有食用海產的記錄,同時他也併發兩側頸部及右小腿的軟組織感染 壞死,亦發生多重器官衰竭。病人於使用靜脈注射ceftazidime,口服doxycycline及右小腿 清創術後得以存活。就我們所知,這名病人是目前文獻發表中的第12例,台灣所發表的第 2例。在回顧有關文獻後,我們呼籲所有免疫機能不全及腎上腺功能不全症的病人,應食用 熟食及避免生食海產。這些高危險群的病人於食用海產後,若出現發燒、腹瀉及軟組織炎, 醫師們一定要把腸炎弧菌感染列入考慮。 |
英文摘要 | Vibrio parahemolyticus (V. parahemolyticus) is a halophilic gram-negative bacillus that lives in the ocean. It is the leading cause of infectious diarrhea in Taiwan and sometimes produces soft tissue infections, but it is rarely a cause of bacteremia. There have been only 11 cases reported in the literature. Most of the cases involved a history of ingestion of seafood or exposure to seawater. In addition, those patients were all immunosuppressed, especially with leukemia and cirrhosis. We report a 60-year-old male patient with chronic hepatitis C and adrenal insufficiency. He developed V. parahemolyticus bacteremia following ingestion of seafood one week prior to admission. His condition was complicated with neck and right lower leg soft tissue infection, as well as multiple organ failure. The patient survived after intravenous ceftazidime, oral doxycycline, and surgical debridement. To our knowledge, this is the 12th reported cases on Medline,and the second bacteremic case in Taiwan. After reviewing the literature, we suggest that all patients with immunosuppressed conditions or adrenal insufficiency should eat foods that are well cooked and avoid raw seafood. Moreever, when patients who are at risk to develop fever, diarrhea, and soft tissue infection after ingestion of seafood, V. parahemolyticus infection should be suspected. All culture specimens should be inoculated on Vibrios selective media. |
本系統中英文摘要資訊取自各篇刊載內容。