社区获得性耐多药肺炎、菌血症和感染性心内膜炎:病例报告

Basavaraj Jatteppanavar, A. Choudhury, P. K. Panda, M. Bairwa
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摘要

背景 全球耐多药(MDR)细菌的流行率有所上升,广泛耐药(XDR)细菌对患者构成威胁。病例摘要 本病例报告描述了一名因疑似热带热感染而入院的年轻人,他的健康状况迅速恶化。尽管热带热感染的检查结果呈阴性,但他出现了中性粒细胞白细胞增多、急性肾损伤和胸部影像学检查结果提示的双侧合并症。第二天,他被诊断为感染性心内膜炎,可能患有风湿性心脏病和耐甲氧西林金黄色葡萄球菌菌血症,以及社区获得性肺炎。尽管使用了广谱抗生素治疗,但他没有任何反应,在第五天死亡。结论 本病例突出表明,临床医生/公众应注意社区获得性耐药菌肺炎、菌血症和心内膜炎,这些疾病最终会导致高发病率和高死亡率。及早识别致病菌株并及时进行抗生素治疗是控制和预防早期死亡的关键。同时,对社区获得性 MDR/XDR 病原体进行病因分析也是一项全球性需求。
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Community-acquired multidrug-resistant pneumonia, bacteraemia, and infective endocarditis: A case report
BACKGROUND The prevalence of multidrug-resistant (MDR) bacteria has increased globally, with extensive drug-resistant (XDR) bacteria posing a threat to patients. CASE SUMMARY This case report describes a young man admitted for suspected tropical fever infections who experienced rapid deterioration in health. Despite negative results for tropical fever infections, he had neutrophilic leucocytosis, acute kidney injury, and chest imaging findings suggestive of bilateral consolidations. On day two, he was diagnosed with infective endocarditis with possible rheumatic heart disease and MDR methicillin-resistant Staphylococcus aureus bacteraemia, and community-acquired pneumonia. Despite treatment with broad-spectrum antibiotics, he did not respond and succumbed to death on day five. CONCLUSION This case highlights that clinicians/public should be aware of MDR community-acquired pneumonia, bacteraemia, and endocarditis which ultimately culminate in high rates of morbidity and mortality. Early identification of pathogenic strain and prompt antibiotic treatment are a mainstay for the management and prevention of early fatalities. Simultaneously, route cause analysis of community-acquired MDR/XDR pathogens is a global need.
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