一名使用中心静脉导管的患者因 Kocuria kristinae 引起的血源性肺炎

Raffaele Natale, Clelia Nasti, Annadora Morena, Fabrizio Pasanisi, L. Santarpia
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引用次数: 0

摘要

Kocuria kristinae 是一种革兰氏阳性共生细菌,很少引起免疫力低下患者的感染。一名 29 岁的女性因肠道假性梗阻而需要家庭肠外营养,在通过长期中心静脉导管(CVC)输液期间因发热和颤抖而住院。血液培养呈 K. kristinae 感染阳性。胸部 CT 扫描显示有两个部分空洞的结节性病变。在局部和全身使用美罗培南抗生素治疗后,导管恢复了使用。两个月后的随访胸部 CT 扫描显示,两块厘米大小的纤维化和通风不良区域取代了之前的结节性增厚。Kokuria kristinae 是造成肺部血源性受累并伴有挖掘结节的原因,需要进行鉴别诊断。此外,在 CVC 感染的情况下,除了右心内膜炎的风险外,还必须考虑血源性肺炎。
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Haematogenous pneumonia caused by Kocuria kristinae in a patient with a central venous catheter
Kocuria kristinae is a Gram-positive commensal bacterium, rarely responsible for infection in immunocompromised patients. A 29-year-old woman affected by intestinal pseudo-obstruction and requiring home parenteral nutrition, was hospitalised for fever and shivering during the infusion through a long-term central venous catheter (CVC). Blood cultures were positive for K. kristinae infection. At a chest CT scan, two partially cavitated nodular lesions were evidenced. Meropenem antibiotic therapy was used locally and systemically, resulting in catheter use restoration. A chest CT scan two months later at follow-up showed two centimetric, fibrotic and disventilatory areas replacing the previous nodular thickenings. Kokuria kristinae was responsible for haematogenous pulmonary involvement with excavated nodules, requiring a differential diagnosis. Moreover, in the case of a CVC infection, in addition to the risk of right endocarditis, haematogenous pneumonia must also be considered.
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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