一例与远端胆管癌相关的高病毒性肺炎克雷伯菌肝脓肿和细菌性眼内炎罕见病例。

IF 0.8 Q4 GASTROENTEROLOGY & HEPATOLOGY Clinical Journal of Gastroenterology Pub Date : 2024-08-01 Epub Date: 2024-06-18 DOI:10.1007/s12328-024-01985-0
Yasuhisa Ando, Hiroyuki Matsukawa, Hironobu Suto, Minoru Oshima, Takayuki Sanomura, Hideki Kamada, Kensuke Kumamoto, Kyoko Yokota, Yasuyuki Suzuki, Keiichi Okano
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引用次数: 0

摘要

我们报告了一例远端胆管癌患者因肝脓肿而出现眼痛和眼红的病例。患者在等待手术期间出现肝脓肿。由于发现了高粘度肺炎克雷伯菌,且影像学检查显示全身感染,因此诊断为克雷伯菌侵袭综合征。此外,还同时发现了感染性眼内炎。除了抗生素治疗外,玻璃体切除术和经皮经肝脓肿引流术成功地使炎症反应恢复正常,并获得了阴性血培养结果。治疗开始 34 天后进行了手术,术后过程顺利,患者于术后第 39 天出院。手术后 46 个月,没有证据表明胆管癌复发或感染复发,但遗憾的是,右眼视力仍然下降。一些肺炎克雷伯氏菌具有很强的致病性,经常有来自东南亚的报道,眼痛和充血症状是重要的体征。
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A rare case of hypervirulent Klebsiella pneumoniae liver abscess and bacterial endophthalmitis associated with distal bile duct cancer.

We report a case of a patient with distal bile duct cancer who presented with ocular pain and eye redness due to a liver abscess. The patient developed a liver abscess while waiting for surgery. Since Klebsiella pneumoniae with high viscosity was identified and imaging studies showed systemic infection, a diagnosis of klebsiella invasive syndrome was made. In addition, infectious intraocular inflammation was also observed at the same time. In addition to antibiotic therapy, vitrectomy and percutaneous transhepatic abscess drainage successfully normalized the inflammatory response and negative blood cultures were obtained. Thirty-four days after the start of treatment, surgery was performed and the postoperative course was uneventful, and the patient was discharged from the hospital on the 39th postoperative day. Forty-six months after that surgery, there has been no evidence of recurrence of cholangiocarcinoma or recurrence of infection, but unfortunately, vision loss in the right eye remains. Some Klebsiella pneumoniae are highly pathogenic and are often reported from Southeast Asia, and ocular pain and hyperemic symptoms are important physical findings.

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来源期刊
Clinical Journal of Gastroenterology
Clinical Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.00
自引率
0.00%
发文量
182
期刊介绍: The journal publishes Case Reports and Clinical Reviews on all aspects of the digestive tract, liver, biliary tract, and pancreas. Critical Case Reports that show originality or have educational implications for diagnosis and treatment are especially encouraged for submission. Personal reviews of clinical gastroenterology are also welcomed. The journal aims for quick publication of such critical Case Reports and Clinical Reviews.
期刊最新文献
Symptomatic hepatic cyst treated with endoscopic ultrasound-guided drainage and minocycline hydrochloride injection: a case report. A small bowel adenocarcinoma harboring a DDR2 mutation in a celiac patient. A case of undifferentiated pleomorphic rectal sarcoma occurring after radiation exposure. Abscopal effect in a patient with advanced hepatocellular carcinoma upon resuming bevacizumab in combination with atezolizumab after radiotherapy. Rapid deterioration of steatotic liver disease due to portal vein stenosis after pancreaticoduodenectomy.
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