IDCases最新文献 - Book学术

Saved by My Specs: Incidental central retinal vein occlusion uncovering infective endocarditis – A case report 偶然的视网膜中央静脉阻塞发现感染性心内膜炎- 1例报告

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02484

Daniel Broderick , Ciara Murray , Padraig McGettrick , James Woo , Emer Kilbride , James McCarthy , Yvonne O’Meara , Varisha Shahzad , Carlos Mejia-Chew

We describe a case of a 74-year-old man with a history of bioprosthetic aortic valve replacement who was diagnosed with Granulicatella adiacens (G. adiacens) infective endocarditis (IE) following an incidental finding of central retinal vein occlusion (CRVO) during a routine optician visit. Despite minimal symptoms on presentation, blood cultures grew G. adiacens, and imaging revealed a 1 × 1.2 cm aortic valve vegetation plus splenic and cerebral embolic complications. Management was complicated by drug-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, microangiopathic thrombocytopenia, anaemia, and possible subacute glomerulonephritis, leading to deferral of surgery until haematological parameters improved. Following a 9-week antibiotic course and stabilisation of platelet counts, he underwent a successful redo aortic valve replacement, highlighting the indolent yet clinically significant nature of G. adiacens IE and the importance of thorough, multidisciplinary care in complex prosthetic valve infections.

我们描述了一个病例74岁的男子与生物假体主动脉瓣置换术的历史，谁被诊断为肉芽肿（G. adiacens）感染性心内膜炎（IE）后偶然发现视网膜中央静脉闭塞（CRVO）在常规验光。尽管出现时症状轻微，但血培养培养出了棘球蚴，影像学显示主动脉瓣1 × 1.2 cm赘生物，并伴有脾和脑栓塞并发症。治疗伴有药物性药物性皮疹伴嗜酸性粒细胞增多和全身症状（DRESS）综合征、微血管病性血小板减少症、贫血和可能的亚急性肾小球肾炎，导致手术推迟至血液学参数改善。经过9周的抗生素治疗和血小板计数稳定后，他进行了成功的主动脉瓣置换术，强调了G. adiacens IE的惰性但临床意义重大的性质，以及在复杂的人工瓣膜感染中进行全面、多学科护理的重要性。

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引用次数: 0

Early recognition and multidisciplinary care in a pediatric patient with acute infectious purpura fulminans due to MRSA: A rare case report 早期识别和多学科护理儿科患者急性感染性暴发性紫癜由于MRSA：一个罕见的病例报告

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02486

Mian Muhammad Hassan Ahmed , Nighat Haider , Samra Batool , Muhammad Usman Ali , Rafia Ishtiaq

Acute infectious purpura fulminans (PF) is a rare but life-threatening condition characterized by rapidly progressive purpura, skin necrosis, and disseminated intravascular coagulation. We present a case of a 4-year-old male child who presented with a high-grade fever, maculopapular rash, encephalopathy, and gangrene of distal digits of hands and feet. The child had a tender right submandibular swelling and hepatomegaly. Laboratory findings included leukocytosis (26.48 × 10^9/L), thrombocytopenia (28,000/µL), an elevated C-reactive protein (296 mg/L), and coagulopathy (INR 1.84, D-dimer 540 ng/mL). Imaging revealed submandibular abscess and an extensive infiltrates in the right lower lobe of the lung. Blood culture and pus culture from neck swelling yielded methicillin-resistant Staphylococcus aureus (MRSA) infection. The child was treated with intravenous vancomycin (15 mg/kg every 6 h) and linezolid (10 mg/kg every 8 h) for 4 weeks, heparin infusion (20 units/kg/hour), and supportive management, followed by oral rivaroxaban (1 mg/kg twice daily) for the next 6 months. Plastic surgery was consulted for gangrene. This case highlights the importance of early recognition, targeted antimicrobial therapy, and multidisciplinary management of PF secondary to MRSA infection in children.

急性感染性暴发性紫癜（PF）是一种罕见但危及生命的疾病，其特征是迅速进展的紫癜，皮肤坏死和弥漫性血管内凝血。我们提出一个病例4岁的男孩谁提出了一个高度发烧，斑疹丘疹，脑病，并坏疽远指的手和脚。患儿右侧下颌骨下有压痛性肿胀，肝肿大。实验室结果包括白细胞增多（26.48 × 10^9/L）、血小板减少（28000 /µL）、c反应蛋白升高（296 mg/L）和凝血功能障碍（INR 1.84， d -二聚体540 ng/mL）。影像学显示下颌骨脓肿及肺右下叶广泛浸润。颈部肿胀的血培养和脓液培养结果为耐甲氧西林金黄色葡萄球菌（MRSA）感染。患儿接受静脉万古霉素（每6 h 15 mg/kg）和利奈唑胺（每8 h 10 mg/kg）治疗4周，肝素输注（20单位/kg/小时）和支持性治疗，随后6个月口服利伐沙班（1 mg/kg，每日两次）。因坏疽而进行整形手术。该病例强调了早期识别、靶向抗菌治疗和多学科管理继发于MRSA感染儿童PF的重要性。

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引用次数: 0

A rare case of Streptomyces fradiae hand actinomycetoma 传统链霉菌手部放线菌瘤1例

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02494

Ajithkumar Ittaman , Hamad Abdel Hadi , Azeel Alziddeh , Mohammed Muneer , Mohammad Z. Haider , Muna Al. Maslamani

Actinomycetoma is a rare, chronic, and progressive bacterial and fungal infection that affects subcutaneous tissues, fascia, and bones. This a case of a 27-year-old Sudanese male, shepherd, with a mycetoma lesion in the right hand caused by Streptomyces fradiae. He presented with swelling and deformity of the hand, and subsequent imaging showed soft tissue swelling, deep infiltration of the hand and sinus formation. A skin biopsy of the lesion confirmed the diagnosis of actinomycetoma, and the patient was treated with ceftriaxone IV for 14 days followed by oral amoxicillin clavulanic acid for a total of 3 months. Surgical excision followed by reconstruction of the hand was performed. Histopathological examination of the excised tissue showed abscess formation around colonies of actinomyces. The patient had significant clinical recovery with no recurrence of the infection. Streptomyces fradiae is a rare causative agent of actinomycetoma, and this case highlights the importance of early diagnosis and prolonged antibiotic therapy in the management of this infection.

放线菌瘤是一种罕见的慢性进行性细菌和真菌感染，影响皮下组织、筋膜和骨骼。这是一例27岁苏丹男性牧羊人，右手由传统链霉菌引起的足菌肿病变。他表现为手部肿胀和畸形，随后的影像学显示软组织肿胀，手部深度浸润和窦形成。病变皮肤活检证实为放线菌瘤，患者给予头孢曲松IV治疗14天，随后口服阿莫西林克拉维酸治疗3个月。手术切除后进行手部重建。组织病理学检查显示放线菌菌落周围形成脓肿。患者临床恢复明显，无感染复发。传统链霉菌是一种罕见的放线菌瘤病原体，本病例强调了早期诊断和长期抗生素治疗在这种感染管理中的重要性。

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引用次数: 0

Fournier’s gangrene caused by Pediococcus damnosus – A case report and review of the literature 沙棘Pediococcus damnosus致Fournier坏疽1例报告及文献复习

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02496

Osamu Okamoto , Kayo Yokoyama , Teruko Suematsu , Kosuke Akishino , Sekinori Munemoto , Yoshitaka Kai

The anaerobic bacterium Pediococcus damnosus is known to be associated with beer or wine spoilage in breweries, and human infection with Pediococcus damnosus has never been reported. A man with severe diabetes mellitus and diabetic nephropathy consulted our clinic because of painful swelling of the scrotal skin and a fever. The patient was diagnosed with Fournier’s gangrene, and Pediococcus damnosus was exclusively isolated from the exudate. Finally, one of the testes became necrotic and was excised. This is the first case of human infection by Pediococcus damnosus and primary skin infection due to Pediococcus species.

厌氧细菌丹诺球菌已知与啤酒厂的啤酒或葡萄酒变质有关，人类感染丹诺球菌从未报道过。一名患有严重糖尿病及糖尿病肾病的男子，因阴囊皮肤肿胀疼痛及发烧而求诊。患者被诊断为富尼耶坏疽，从渗出液中完全分离出沙棘球球菌。最后，其中一个睾丸坏死并被切除。这是首例人类感染沙棘球绦虫和由球绦虫引起的原发性皮肤感染病例。

引用次数: 0

Acute pancreatitis as a complication of epstein-barr virus infection: A case report and narrative review 急性胰腺炎作为爱泼斯坦-巴尔病毒感染的并发症：一个病例报告和叙述回顾

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02469

Joe Zako , Gilbert Cornut , Alexandra Monière-Wollank

Background

Epstein–Barr virus (EBV) infection is common, but EBV-associated acute pancreatitis is rare and heterogeneous. We describe an adult case and synthesize published cases to inform diagnosis and management.

Case presentation

A 40-year-old man presented with sore throat and mild abdominal pain; examination showed a right peritonsillar abscess with uvular deviation. Laboratory testing revealed lipase 3704 U/L and elevated inflammatory markers; abdominal CT confirmed non-complicated acute pancreatitis. He received incision and drainage of the abscess plus conservative pancreatitis care. Symptoms resolved rapidly, lipase decreased to 352 U/L by day 2, and he was subsequently discharged. EBV serology later confirmed acute infection, and patient was asymptomatic at 2-month follow-up.

Methods

We searched PubMed to August 24, 2025, using (“Epstein-Barr virus” OR “EBV”) AND “pancreatitis,” including human case reports or series of EBV-associated acute pancreatitis. There were no language restrictions.

Results

Of 60 records, 13 cases met criteria. Eight involved adults and most patients were female. Abdominal pain was common, but classic mononucleosis symptoms were infrequently reported. CT was the predominant diagnostic modality. Management was conservative in nearly all reports and antivirals were rarely used. Outcomes were generally favorable, with one fatal case.

Conclusions

EBV should be considered in unexplained acute pancreatitis, particularly when common etiologies are excluded or concurrent EBV features are present. Prognosis is typically good with supportive care, but coexisting risk factors may predispose patients to a more severe or complicated course. Transparent reporting of cofactors will clarify whether EBV acts as an opportunistic trigger or independent cause.

eb病毒（depstein - barr virus， EBV）感染是常见的，但EBV相关的急性胰腺炎是罕见且异质性的。我们描述了一个成人病例，并综合了已发表的病例，以告知诊断和管理。病例表现：40岁男性，以喉咙痛、轻度腹痛为主；检查显示右腋窝周围脓肿伴小舌偏曲。实验室检测显示脂肪酶3704 U/L和炎症标志物升高；腹部CT证实无并发症的急性胰腺炎。他接受了脓肿切开引流和保守的胰腺炎治疗。症状迅速缓解，第2天脂肪酶降至352 U/L，随后出院。EBV血清学证实急性感染，随访2个月无症状。方法我们检索PubMed至2025年8月24日，使用“eb病毒”和“胰腺炎”，包括人类病例报告或一系列eb病毒相关的急性胰腺炎。没有语言限制。结果60例患者中，符合标准13例。8名患者为成年人，大多数患者为女性。腹痛是常见的，但典型的单核细胞增多症症状很少报道。CT是主要的诊断方式。在几乎所有的报告中，治疗都是保守的，并且很少使用抗病毒药物。结果总体上是有利的，只有1例死亡。结论不明原因的急性胰腺炎应考虑sebv，特别是在排除常见病因或同时存在EBV特征的情况下。支持治疗的预后通常良好，但共存的危险因素可能使患者易患更严重或更复杂的病程。辅助因素的透明报告将澄清EBV是作为机会性触发因素还是独立原因。

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引用次数: 0

A rare case of non-wound tetanus mimicking botulism successfully managed in the ICU 一例罕见的非创伤性破伤风模拟肉毒杆菌中毒在ICU成功处理

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02476

Erdem Yalcinkaya , Umut Sabri Kasapoğlu , Hasan Basri Yapici , Begum Tamer

Background

Tetanus and botulism are neurotoxin-mediated diseases caused by Clostridium species but differ in their clinical manifestations and mechanisms of paralysis.

Case

A 36-year-old woman presented with presented with rapidly progressive trismus, dysarthria, and facial paresthesia without an identifiable wound. Neuroimaging was normal. She had undergone laser eye surgery two days earlier and consumed home-canned food two weeks before admission. One month prior, her house had been flooded, and she recalled possible minor hand injuries sustained during post-flood cleaning. Given the typical rigidity and absence of focal neurological lesions, tetanus was suspected. Human tetanus immunoglobulin (HTIG, 500 IU intramuscularly) and intravenous metronidazole were administered, leading to complete resolution of symptoms within 24 h.

Conclusion

This case illustrates that even minimal or unnoticed injuries can serve as a portal of entry for Clostridium tetani. Non-wound tetanus should be considered in patients presenting with trismus and cranial symptoms, even when no wound is apparent.

破伤风和肉毒杆菌中毒是由梭状芽胞杆菌引起的神经毒素介导的疾病，但它们的临床表现和麻痹机制不同。病例1,36岁女性，表现为快速进行性牙关、构音障碍和面部感觉异常，无明显伤口。神经影像学检查正常。她在入院前两天接受了激光眼科手术，并在入院前两周食用了家庭罐头食品。一个月前，她的房子被洪水淹没，她回忆起在洪水后的清洁工作中手部可能受了轻伤。鉴于典型的僵硬和没有局灶性神经病变，怀疑破伤风。人破伤风免疫球蛋白（HTIG，肌肉注射500 IU）和静脉注射甲硝唑，症状在24 h内完全消退。结论本病例表明，即使是微小的或未被注意到的损伤也可以作为破伤风梭菌的进入门户。即使没有明显的伤口，出现咬牙和颅部症状的患者也应考虑非创伤性破伤风。

{"title":"A rare case of non-wound tetanus mimicking botulism successfully managed in the ICU","authors":"Erdem Yalcinkaya , Umut Sabri Kasapoğlu , Hasan Basri Yapici , Begum Tamer","doi":"10.1016/j.idcr.2025.e02476","DOIUrl":"10.1016/j.idcr.2025.e02476","url":null,"abstract":"<div><h3>Background</h3><div>Tetanus and botulism are neurotoxin-mediated diseases caused by <em>Clostridium species but differ in their clinical manifestations and mechanisms of paralysis.</em></div></div><div><h3>Case</h3><div>A 36-year-old woman presented with presented with rapidly progressive trismus, dysarthria, and facial paresthesia without an identifiable wound. Neuroimaging was normal. She had undergone laser eye surgery two days earlier and consumed home-canned food two weeks before admission. One month prior, her house had been flooded, and she recalled possible minor hand injuries sustained during post-flood cleaning. Given the typical rigidity and absence of focal neurological lesions, tetanus was suspected. Human tetanus immunoglobulin (HTIG, 500 IU intramuscularly) and intravenous metronidazole were administered, leading to complete resolution of symptoms within 24 h.</div></div><div><h3>Conclusion</h3><div>This case illustrates that even minimal or unnoticed injuries can serve as a portal of entry for <em>Clostridium tetani</em>. Non-wound tetanus should be considered in patients presenting with trismus and cranial symptoms, even when no wound is apparent.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02476"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of osteoarticular melioidosis misdiagnosed as extra-pulmonary tuberculosis from low endemicity region in North-western India 印度西北部低流行区一例骨关节类鼻疽误诊为肺外结核

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02472

Rushika Saksena , Disha Gautam , Kavita Sisodia , Ashish Jaiman , Vivek Yadav , Dharmendra Kumar Singh , Rohit Kumar

We report a rare case of melioidosis involving femur and knee in a 62-year old diabetic male patient from low endemic region (Kota, Rajasthan, India). He was previously misdiagnosed as case of extra-pulmonary tuberculosis (EPTB). Patient’s occupation (house building contractor) involving damp and humid soil for construction and non-response to anti-tubercular treatment aroused suspicion of melioidosis. Burkholderia pseudomallei was isolated on culture of pus aspirated from the non-healing osteo-articular lesions and confirmed by real-time PCR targeting T3SS1 gene (Type-3 secretion system 1). Although melioidosis is classified as a tropical disease of wet and humid climate, rare autochthonous cases have also been reported from arid regions in India (Rajasthan, Gujarat and Punjab). We propose that there might be environmental presence of B. pseudomallei in otherwise arid regions, demonstrated in this case where construction sites involving old or new buildings with predominantly moist soil was the likely source of infection. Therefore, a high index of suspicion for melioidosis in non-endemic areas is essential for early detection and treatment of melioidosis.

我们报告一例罕见的类鼻疽病累及股骨和膝关节的62岁男性糖尿病患者来自低流行地区（Kota, Rajasthan，印度）。他以前被误诊为肺外结核（EPTB）病例。患者职业（房屋建筑承包商）涉及潮湿土壤施工，抗结核治疗无效，疑为类鼻疽。从未愈合的骨关节病变中抽吸脓液培养分离到假马氏伯克氏菌，并通过实时PCR检测T3SS1基因（3型分泌系统1）。虽然类鼻疽病被归类为潮湿和潮湿气候的热带疾病，但在印度干旱地区（拉贾斯坦邦、古吉拉特邦和旁遮普邦）也报告了罕见的本地病例。我们提出，在干旱地区可能存在假芽孢杆菌的环境存在，在这种情况下，涉及湿土为主的新旧建筑的建筑工地可能是感染源。因此，在非类鼻疽流行地区对类鼻疽病的高怀疑指数对于早期发现和治疗类鼻疽病至关重要。

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引用次数: 0

Mycobacterium abscessus lumbar osteomyelitis: A rare and challenging case with review of literature 脓肿分枝杆菌腰椎骨髓炎：一个罕见且具有挑战性的病例与文献回顾

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02495

Mohammed S. Zaman , Rootul Kakadia , Abhinav Kakuturu , Moamen Al Zoubi

A 65-year-old male presented with a three-month history of back pain, increased urinary frequency and lower extremity edema. MRI spine suggested discitis/osteomyelitis at L3-L4 (Fig. 1), and blood cultures and lumbar biopsy grew gram-positive bacilli. Despite IV antibiotics, the patient continued to experience back pain. Subsequent cultures identified Mycobacterium abscessus. He was initially treated with IV amikacin, IV meropenem, IV tigecycline, and oral linezolid. He also underwent L3-L4 discectomy, fusion, and posterior L2-L5 fusion with drain placement. He was discharged on IV tigecycline, imipenem, amikacin, and oral linezolid, later transitioning to oral omadacycline, azithromycin, and linezolid (Table 1). This case illustrates the challenges of managing Mycobacterium abscessus (MAB) infections, which require a multi-drug approach due to intrinsic and acquired antibiotic resistance. Therapy should begin with in-vitro guided IV antibiotics and transition to oral drugs for the continuation phase, optimizing therapeutic efficacy and overcoming resistance mechanisms.

65岁男性，有三个月的背痛病史，尿频增加，下肢水肿。脊柱MRI提示L3-L4椎间盘炎/骨髓炎（图1），血培养和腰椎活检显示革兰氏阳性杆菌。尽管静脉注射了抗生素，病人仍然感到背部疼痛。随后的培养鉴定为脓肿分枝杆菌。他最初接受阿米卡星、美罗培南、替加环素和口服利奈唑胺的治疗。他还接受了L3-L4椎间盘切除术、融合术和后路L2-L5融合术并放置引流管。出院时给予静脉滴注替加环素、亚胺培南、阿米卡星和口服利奈唑胺，后来转为口服奥马达环素、阿奇霉素和利奈唑胺（表1）。该病例说明了管理脓肿分枝杆菌（MAB）感染的挑战，由于固有和获得性抗生素耐药性，需要多种药物治疗。治疗应从体外引导静脉注射抗生素开始，并在持续阶段过渡到口服药物，以优化治疗效果并克服耐药机制。

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引用次数: 0

Misleading presentation of tuberculosis in a child with CGD revealing invasive aspergillosis: A molecularly confirmed case CGD患儿结核的误导表现显示侵袭性曲霉病：一个分子确诊病例

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02499

Marjan Aghajani , Nima Parvaneh , Shahram Mahmoudi , Mahmoud Khansari , Fuad Haghighat , Kimia Kamali Sarvestani , Romina Ghazi Mirsaid , Hasti Kamali Sarvestani

Background and Purpose

Patients with chronic granulomatous disease (CGD) are susceptible to serious infections including, invasive aspergillosis (IA), which remains a major cause of morbidity and mortality. The diagnosis and management are often challenging due to overlapping clinical features and variable treatment responses.

Case report

Here we report a 4-year-old girl with CGD who admitted with cellulitis, a chest wall abscess, and fever. She had a history of recurrent pneumonia since infancy and a prior diagnosis of tuberculosis (TB). Despite broad-spectrum antibacterial, her condition did not improve. Direct microscopic and macroscopic investigations revealed fungal infection with Aspergillus species.

Conclusion

Molecular identification confirmed the isolates as A. fumigatus. According to the antifungal susceptibility testing, amphotericin B and posaconazole demonstrated strongest activity and the patient was successfully treated by liposomal amphotericin B (50 mg/day) and caspofungin (35 mg/day).

背景和目的慢性肉芽肿病（CGD）患者易受严重感染，包括侵袭性曲霉病（IA），这仍然是发病率和死亡率的主要原因。由于重叠的临床特征和不同的治疗反应，诊断和管理往往具有挑战性。病例报告：我们报告一名4岁的CGD女孩，她因蜂窝组织炎，胸壁脓肿和发烧而入院。她自婴儿期就有复发性肺炎病史，既往诊断为结核病。尽管使用了广谱抗菌药物，她的病情并没有好转。直接的显微和宏观调查显示真菌感染的曲霉种类。结论经分子鉴定，分离物为烟螨。抗真菌药敏试验两性霉素B和泊沙康唑活性最强，经两性霉素B脂质体（50 mg/d）和卡泊芬金（35 mg/d）治疗成功。

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引用次数: 0

Paeniclostridium sordelli toxic shock syndrome after a septic abortion – A case report 败血性流产后索德利小梭菌中毒性休克综合征1例

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02467

Greeshmasree Kambam , Robbert Crusio

Paeniclostridium sordellii is a highly virulent, spore-forming, Gram-positive anaerobe responsible for life-threatening infections, including endocarditis, myositis, and toxic shock syndrome. Although less well known than other clostridial species, it poses a significant risk, particularly to postpartum women, intravenous drug users, and the immunocompromised. In recent times, clostridial sepsis with toxic shock syndrome is more commonly seen in patients who underwent medical abortion and IV drug users, with mortality as high as 70 % within a few days of symptom onset. Here, we present a case of severe toxic shock syndrome caused by P.sordellii in a young woman presenting 6 days after medical abortion, with a leukemoid reaction (max WBC 53,000/µL) and rapidly progressive shock due to Toxic shock syndrome (TSS). Despite initial medical management with broad-spectrum antibiotics and supportive care, she required hysterectomy for definitive source control and 29 days of hospitalization, including ECMO support for refractory shock. The hospital course was further complicated by acute kidney injury, anemia, thrombocytopenia and volume overload. A high degree of suspicion, the prompt initiation of broad-spectrum antibiotics, and timely source control are essential in preventing mortality.

sordellipaeniclostridium sordellii是一种高毒力、孢子形成、革兰氏阳性厌氧菌，可导致危及生命的感染，包括心内膜炎、肌炎和中毒性休克综合征。虽然不像其他梭状菌那样为人所知，但它具有重大风险，特别是对产后妇女、静脉注射吸毒者和免疫功能低下者。近年来，梭状芽孢杆菌脓毒症合并中毒性休克综合征在药物流产和静脉吸毒患者中更为常见，在症状出现后几天内死亡率高达70% %。在这里，我们报告了一例由索代氏P.sordellii引起的严重中毒性休克综合征，发生在药物流产后6天的年轻女性，伴有白血病反应（最大WBC 53,000/µL），并因中毒性休克综合征（TSS）而迅速进展性休克。尽管最初的医疗管理是广谱抗生素和支持性护理，但她需要子宫切除术以确定病因控制，并住院29天，包括对难治性休克的ECMO支持。急性肾损伤、贫血、血小板减少和容量超载使住院过程进一步复杂化。高度怀疑、迅速使用广谱抗生素和及时控制传染源对预防死亡至关重要。

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引用次数: 0