与远端胆管癌相关的高毒力肺炎克雷伯菌肝脓肿和细菌性眼内炎的罕见病例。
A rare case of hypervirulent Klebsiella pneumoniae liver abscess and bacterial endophthalmitis associated with distal bile duct cancer.
发表日期:2024 Jun 18
作者:
Yasuhisa Ando, Hiroyuki Matsukawa, Hironobu Suto, Minoru Oshima, Takayuki Sanomura, Hideki Kamada, Kensuke Kumamoto, Kyoko Yokota, Yasuyuki Suzuki, Keiichi Okano
来源:
PHYSICAL THERAPY & REHABILITATION JOURNAL
摘要:
我们报告了一名远端胆管癌患者的病例,该患者因肝脓肿而出现眼部疼痛和眼睛发红。患者在等待手术期间出现肝脓肿。由于鉴定出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,同时还观察到感染性眼内炎症。除了抗生素治疗外,玻璃体切除术和经皮肝穿刺脓肿引流术成功地使炎症反应正常化,并获得了阴性血培养。治疗开始后34天,进行了手术,术后过程平稳,患者于术后第39天出院。手术后四十六个月,没有证据表明胆管癌复发或感染复发,但不幸的是,右眼视力仍然丧失。一些肺炎克雷伯菌具有高致病性,经常在东南亚报告,眼部疼痛和充血症状是重要的身体发现。© 2024。日本胃肠病学会。
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.© 2024. Japanese Society of Gastroenterology.