[1]吕梅,杨旭,和平安,等.老年患者由产气荚膜梭菌引起肺部和血流感染的临床和实验室分析及相关文献复习[J].现代检验医学杂志,2020,35(05):154-158.[doi:10.3969/j.issn.1671-7414.2020.05.040]
 L? Mei,YANG Xu,HE Ping-an,et al.Clinical and Laboratory Analysis and Literature Review of Pulmonary and Bloodstream Infections Caused by Clostridium Perfringens in Elderly Patients[J].Journal of Modern Laboratory Medicine,2020,35(05):154-158.[doi:10.3969/j.issn.1671-7414.2020.05.040]
点击复制

老年患者由产气荚膜梭菌引起肺部和血流感染的临床和实验室分析及相关文献复习()
分享到:

《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年05期
页码:
154-158
栏目:
检验与临床
出版日期:
2020-11-01

文章信息/Info

Title:
Clinical and Laboratory Analysis and Literature Review of Pulmonary and Bloodstream Infections Caused by Clostridium Perfringens in Elderly Patients
文章编号:
1671-7414(2020)05-154-05
作者:
吕梅杨旭和平安李庆荣陶慧婷张仕茜
昆明医科大学第二附属医院检验科,昆明 650032
Author(s):
L? Mei YANG Xu HE Ping-an LI Qing-rong TAO Hui-tingZHANG Shi-xi
Department of Clinical Laboratory, the Second Affiliated Hospital of Kunming Medical University,Kunming 650032,China
关键词:
产气荚膜梭菌肺部感染胸腔积液血流感染
分类号:
R378.8;R446.5
DOI:
10.3969/j.issn.1671-7414.2020.05.040
文献标志码:
A
摘要:
目的 分析产气荚膜梭菌引起肺部和血流感染的临床和实验室特点,为临床诊治提供依据。方法 报道一例产 气荚膜梭菌引起肺部感染和血流感染的病例,检索产气荚膜梭菌引起的肺部感染、血流感染文献,结合报道回顾性分析 其临床和实验室特点。结果 报道者系并发慢性疾病的老年男性,胸腔积液和血液分离出产气荚膜梭菌,经抗感染和引 流治疗后,临床症状好转。检索到详尽记录的肺部感染或胸腔积液和血流感染文献各29 例和33 例。29 例肺部感染患者中, 男性21 例和女性8 例,26 例患者伴慢性疾病。临床表现相似,前四位的症状和体征为呼吸困难(22 例)、胸痛(15 例)、 发热(15 例)和咳嗽(12 例)。胸腔积液早期一般呈浑浊、黄绿色或者稀薄血性,晚期为脓性、棕褐色伴恶臭。33 例 血流感染患者中,男性22 例和女性11 例,26 例伴慢性疾病,临床表现复杂。除并发白血病患者外,白细胞和中性粒 细胞计数不同程度升高,血红蛋白不同程度下降,乳酸脱氢酶显著升高。结论 产气荚膜梭菌引起肺部感染和血流感染 多发于并发慢性疾病的老年男性,肺部感染或胸腔积液临床表现相似。血流感染临床表现复杂, 分离出产气荚膜梭菌是 确诊的依据之一,临床应结合患者基本情况综合诊治。
Abstract:
Objective To analyze the clinical and laboratory characteristics of pulmonary and bloodstream infections caused by Clostridium perfringens(Cp), so as to provide basis for clinical diagnosis and treatment. Methods A case of pulmonary infection and blood flow infection caused by Cp was reported. The literature on pulmonary infection and blood flow infection caused by Cp was searched. Results This report was from an elderly man with chronic disease, who isolated Cp from pleural effusion and blood,after anti-infection and drainage treatment, the clinical symptoms improved.Detailed records of lung infection or pleural effusion and bloodstream infection were retrieved in 29 and 33 cases respectively.Of the 29 patients with pulmonary infection, 21 were males, 8 were females, and 26 were associated with chronic disease.The clinical (15 manifestations were similar, with symptoms and signs of dyspnea (22 cases), chest pain (15 cases), fever cases), and cough (12 cases).Pleural effusion was generally cloudy, yellow-green or thin blood in the early stage, and purulent, tan with stench in the late stage.Among the 33 patients with bloodstream infection, there were 22 males, 11 females and 26 patients with chronic diseases, presenting complex clinical manifestations.In addition to the patients with leukemia, the count of white blood cells and neutrophils increased to different degrees, the hemoglobin decreased to different degrees, and the lactate dehydrogenase increased significantly. Conclusion Pulmonary infection and bloodstream infection caused by Cp mostly occured in elderly men with chronic diseases. The clinical manifestations of pulmonary infection or pleural effusion were similar. The clinical manifestations of bloodstream infection were complex. The isolation of Cp is one of the basis of diagnosis,and the clinical diagnosis and treatment should be combined with the basic situation of patients.

参考文献/References:

[1]  BASNET S, MIR I, MOHANTY E,et al. A rare case of spontaneous empyema by Clostridium perfringens [J]. Case Reports in Infectious Diseases, 2018, 2018:2791349.
[2]  PALMACCI C, ANTOCICCO M, BONOMO L, et al. Necrotizing pneumonia and sepsis due to Clostridium perfringens :a case report[J]. Cases Journal, 2009, 2(1): 50.
[3]  JACKSON S, GREGSON D B, MCFADDEN S, et al. Clostridium perfringens pleuropulmonary infection and septic shock:case report and population-based laboratory surveillance study[J]. Scandinavian Journal of Infectious Diseases, 2003, 35(11/12): 883-886.
[4]  SHINDO Y, DOBASHI Y, SAKAI T, e t a l . Epidemiological and pathobiological profiles of Clostridium perfringens infections:review of consecutive series of 33 cases over a 13-year period[J]. International Journal of Clinical and Experimental Pathology, 2015, 8(1): 569-577.
[5]  DJ O J, BRECHER S, RUOPP M. Clostridium perfringens empyema in a patient with metastatic squamous cell carcinoma of the lung[J]. International Journal of Critical Illness and Injury Science, 2018, 8(2): 104-106.
[6]  ALBUQUERQUE A, MACEDO G. Spontaneous bacterial empyema in a cirrhotic patient due to Clostridium perfringens:case report and review of the literature[J]. Gastroenterologia y Hepatologia, 2013, 36(2): 69-71.
[7]  YAMAGUCHI R, MAKINO Y, CHIBA F, et al. Fatal clostridium perfringens septicemia suggested by postmortem computed tomography: A medicolegal autopsy case report[J]. Forensic Sci Int, 2015,253;e4-e9.
[8]  刘淑芬,胡秀华.血液标本中分离产气荚膜梭菌1 例的报道[J].国际检验医学杂志, 2017, 38(2): 287-288. LIU Shufen, HU Xiuhua. A case of isolated Clostridium perfringens from blood samples [J]. International Journal of Laboratory Medicine, 2017, 38(2): 287-288.
[9]  EL-SOLH A A,PIETRANTONI C,BHAT A,et al. Microbiology of severe aspiration pneumonia in institutionalized elderly[J]. Am J Respir Crit Care Med, 2003, 167(12):1650-1654.
[10] SIMON T G, BRADLEY J, JONES A, et al. Massive intravascular hemolysis from Clostridium perfringens septicemia:a review[J]. Journal of Intensive Care Medicine, 2014, 29(6): 327-333.
[11] 黎斌斌,王春雷,刘颖梅,等. 伴致死性溶血的产 气荚膜梭菌血流感染二例并文献复习[J]. 中华内科 杂志,2014,53(7):565-567.    LI Binbin, WANG Chunlei, LIU Yingmei ,et al. Two cases of Clostridium perfringens infection with fatal hemolysis and literature review [J]. Chin J Intern Med, 2014,53(7): 565-567
[12] BASHIR Y, BENSON M K. Necrotising pneumonia and empyema due to Clostridium perfringens complicating pulmonary embolus[J]. Thorax, 1990, 45(1): 72-73.
[13] LINDBERG ?, WIDE D. Sepsis with intravascular hemolysis caused by clostridium perfringens[J]. Lakartidningen, 2019, 116:FDED.
[14] STEVENS D L, BISNO A L, CHAMBERS H F, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections:2014 update by the Infectious Diseases Society of America[J]. Clinical Infectious Diseases, 2014, 59(2): e10 - e52.
[15] ROBERTS S A, SHORE K P, PAVIOUR S D, et al. Antimicrobial susceptibility of anaerobic bacteria in New Zealand:1999~2003[J]. The Journal of Antimicrobial Chemotherapy, 2006, 57(5): 992-998.
[16] BROOK I. Clostridial infections in children :spectrum and Management[J]. Current Infectious Disease Reports, 2015, 17(11): 47.

相似文献/References:

[1]闫海燕,杨云秀,杨云华,等.老年糖尿病肾病患者血清SP-D水平表达及其基因多态性与并发肺部感染的相关性研究[J].现代检验医学杂志,2021,36(04):21.[doi:10.3969/j.issn.1671-7414.2021.04.005]
 YAN Hai-yan,YANG Yun-xiu,YANG Yun-hua,et al.Research on the Relationship between Serum SP-D Level, Gene Olymorphismand Pulmonary Infection in Elderly Patients with Diabetic Nephropathy[J].Journal of Modern Laboratory Medicine,2021,36(05):21.[doi:10.3969/j.issn.1671-7414.2021.04.005]
[2]孙 莉,马 艳,厉小梅,等.宏基因组二代测序对结缔组织病并发肺部感染的病原学诊断价值研究[J].现代检验医学杂志,2023,38(05):1.[doi:10.3969/j.issn.1671-7414.2023.05.001]
 SUN Li,MA Yan,LI Xiaomei,et al.Value of Metagenomic Next-generation Sequencing in the Pathogenic Diagnosis of Connective Tissue Disease Combined with Pulmonary Infection[J].Journal of Modern Laboratory Medicine,2023,38(05):1.[doi:10.3969/j.issn.1671-7414.2023.05.001]

备注/Memo

备注/Memo:
作者简介:吕梅(1992-),女,硕士研究生,研究方向:感染性疾病的实验室诊断,E-mail: lvmei0826@163.com。 通信作者:杨旭(1972-),女,硕士研究生, 副主任技师, 研究方向:感染性疾病的实验室诊断,E-mail:yx8250696@163.com。
更新日期/Last Update: 2020-10-30