血小板减少性紫癜1例40岁伴有牙齿罗氏菌相关心内膜炎患者

IF 1 Q4 INFECTIOUS DISEASES
Song Jianjian, Jiang Heping, Li Feifei, Gao Kang, Gu Yinghao
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引用次数: 0

摘要

摘要男性,40岁,有口腔病史,以发热、意识不清、紫癜就诊。计算机断层扫描显示蛛网膜下腔出血,血液分析显示血小板减少。患者开始每日静脉注射哌拉西林、他唑巴坦、糖皮质激素和丙种球蛋白。两周后症状好转,但仍有发热、血小板减少、肝脾脓肿、严重心肌损伤等严重并发症。随后,从患者肢体的血液样本中培养牙齿罗氏菌。病人开始每日注射替加环素和青霉素。10天后,患者症状好转,尝试阿米卡星治疗,后证实无效。心脏超声显示主动脉瓣赘生物,核磁共振显示脑脓肿形成。然后将抗生素调整为万古霉素和美罗培南。最后,患者接受了瓣膜置换术。感染性心内膜炎手术后,万古霉素和美罗培南使用一周导致症状消退。病人被转到康复医院。本病例将为牙卡里沙菌的治疗提供临床经验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thrombocytopenic Purpura in a 40-year-old Patient with Rothia dentocariosa-associated Endocarditis
Abstract A 40-year-old male patient with a history of dental disease was sent to the emergency room mainly for fever, unclear consciousness, and purpura. Computed tomography reveals subarachnoid hemorrhage and blood analysis reveals platelet reduction. The patient was started daily intravenous piperacillin tazobactam glucocorticoid and gamma globulin. Two weeks later, symptoms improved but still had severe complications such as fever, platelet reduction, hepatosplenic abscess, and severe myocardial injury. Subsequently, Rothia dentocariosa was cultured from the blood samples of patient’s limb. The patient was started on daily injections of tigecycline and penicillin. Ten days later, symptoms improved and amikacin was tried, which was later confirmed to be ineffective in this patient. Cardiac ultrasound revealed aortic valve vegetations and magnetic resonance imaging revealed brain abscess formation. Then, antibiotics were adjusted to vancomycin and meropenem. Finally, the patient underwent valve replacement. Infectious endocarditis – after surgery, vancomycin and meropenem were utilized for a week leading to symptom resolution. The patient was transferred to rehabilitation hospital. This case will provide clinical experience for the treatment of R. dentocariosa .
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来源期刊
CiteScore
3.30
自引率
0.00%
发文量
31
审稿时长
29 weeks
期刊介绍: JGID encourages research, education and dissemination of knowledge in the field of Infectious Diseases across the world thus promoting translational research by striking a synergy between basic science, clinical medicine and public health. The Journal intends to bring together scientists and academicians in Infectious Diseases to promote translational synergy between Laboratory Science, Clinical Medicine and Public Health. The Journal invites Original Articles, Clinical Investigations, Epidemiological Analysis, Data Protocols, Case Reports, Clinical Photographs, review articles and special commentaries. Students, Residents, Academicians, Public Health experts and scientists are all encouraged to be a part of this initiative by contributing, reviewing and promoting scientific works and science.
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