植入可插入式心脏监护仪后的单端假单胞菌菌血症和败血症:病例报告。

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Medical Case Reports Pub Date : 2024-10-18 DOI:10.1186/s13256-024-04832-5
Dongwhane Lee, Kyung Hwa Jung, Hyo-Ju Son, In Tae Moon
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引用次数: 0

摘要

背景:植入式心脏监护仪是一种简单而安全的手术,通常用于来源不明的栓塞性脑卒中患者。虽然有局部感染或革兰氏阳性菌血症的报道,但由于感染率很低,因此不建议在手术前常规使用抗生素。我们报告了一例插入式心脏监护仪植入术后立即发生假单胞菌败血症的病例:一名 55 岁的韩国男性因不明原因的栓塞性中风在植入式心脏监护仪后立即出现革兰氏阴性败血症,这是植入式心脏监护仪术后首次报告的并发症。经血液培养确定为假单胞菌,未发现其他感染源。他接受了静脉抗生素治疗,但没有移除装置:结论:对于此类植入式心脏监护仪术后败血症患者,需要及时诊断并采取适当的治疗措施。如果植入部位没有炎症迹象,则可以通过适当的抗生素治疗来控制病情,而无需移除装置。应进一步调查报告或研究,以加强这一结论:插入式心电监护仪插入后的感染率极低;然而,败血症可能在没有口袋感染的情况下发生。医生应注意全身感染的迹象,尤其是在导管室外进行手术时。如果插入部位没有炎症迹象,可通过适当的抗生素治疗来控制插入式心电监护仪植入术后的败血症,而无需移除设备。
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Pseudomonas monteilii bacteremia and sepsis following insertable cardiac monitor implantation: a case report.

Background: Insertable cardiac monitor implantation is a simple and safe procedure commonly performed in patients with embolic stroke with undetermined source. Routine periprocedural antibiotic use is not recommended, because infection rate is very low, although some local infection or gram-positive bacteremia have been reported. We report a case of Pseudomonas monteilii sepsis immediately after insertable cardiac monitor implantation.

Case presentation: A 55-year-old Korean male with embolic stroke of undetermined source presented with gram-negative sepsis immediately after implantable cardiac monitor implantation as a first reported complication after the procedure. Pseudomonas monteilii was identified in the blood culture, and no other infection source was seen. He was treated with intravenous antibiotics without removing the device.

Conclusions: Prompt diagnosis and adequate management is required in such a patient with sepsis post-insertable cardiac monitor implantation procedure. It can be managed with adequate antibiotic treatment without device removal if there is no sign of inflammation at the insertion site. Further reports or studies should be investigated to reinforce this finding.

Learning objectives: The infection rate after insertable cardiac monitor insertion is extremely low; however, sepsis may occur without pocket infections. Physicians should be aware of signs of systemic infection, particularly when the procedure is performed outside the catheterization room. Sepsis after insertable cardiac monitor implantation can be managed with adequate antibiotic treatment without device removal if there is no sign of inflammation at the insertion site.

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来源期刊
Journal of Medical Case Reports
Journal of Medical Case Reports Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
436
期刊介绍: JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
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