伴有过敏样症状的不动杆菌woffii诱导蜂窝织炎

S. Barghouthi, G. Hammad, M. Kurdi
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引用次数: 3

摘要

很少有报告记载因过敏反应而误诊为沃氏不动杆菌皮肤感染。此外,在应用常规诊断方法时,常误诊为A. lwoffii。据报道,这种细菌会导致多种疾病,包括皮肤和伤口感染。应用新建立的方法“通用方法”可以明确鉴定从腿脚蜂窝组织炎病例(隔离QUBC mk1)中分离的细菌,该病例被误诊为过敏反应,并用非甾体类抗炎药双氯芬酸钠肌肉注射治疗。菌株经鉴定为A. lwoffii,在MacConkey琼脂上不能生长,对环丙沙星敏感,对头孢唑啉耐药。51岁男性患者经静脉给予环丙沙星、多西林、头孢唑林成功治疗。十天后,他健康地出院了。这项工作强调了区分皮肤感染和过敏的重要性。同时也强调了及时、准确地鉴定洛菲菌及其与过敏反应的可能关系的重要性。在“卫生假说”的背景下讨论误诊。
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Acinetobacterlwoffii Induced Cellulitis with Allergy-like Symptoms
Few reports document the misdiagnosis of Acinetobacterlwoffii skin infections for allergic reactions. In addition, A. lwoffii is frequently misidentified when applying conventional diagnostic methods. The bacterium has been reported to cause a multitude of diseases including skin and wound infections. The application of the newly established method “The Universal Method” allowed definite identification of the bacterium isolated from a leg and foot cellulitis case (Isolate QUBC mk1) that was misdiagnosed as an allergic reaction and was treated with intramuscular injections of diclofeneac sodium, anonsteroidal antiinflammatory drug.The isolate was identified as A. lwoffii, it failed to grow on MacConkey agar, and it was sensitive to ciprofloxacin but resistant to cefazolin. The 51-year old male patient was successfully treated with intravenous administration of ciprofloxacin, doxacillin, and cefazolin. He was released in good health after ten days.This work emphasizes the importance of distinguishing between skin infections and allergies. It also stresses the importance of prompt and accurate identification of A. Lwoffii and its possible relationship to allergic reactions. Misdiagnosis isdiscussed in the context of “The Hygiene Hypothesis”.
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