支气管哮喘患者单侧并发胸膜脓胸1例,原因为耐克林霉素结核菌普氏菌。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Archive of clinical cases Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI:10.22551/2023.41.1004.10263
Sakshi Patel, Hamza Hanfe, Alkesh Kumar Khurana, Arati Bhadade, Shashwati Nema
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引用次数: 0

摘要

布氏普雷沃氏菌(P. buccae)是一种革兰氏阴性专性厌氧菌,主要与牙源性感染有关。由这些专性厌氧菌引起的非口腔单菌感染是罕见的。只有少数病例的单菌非口腔感染的布氏假单胞菌已在文献报道。我们报告一例单侧并发胸膜积气肿的患者支气管哮喘感染假单胞杆菌。胸水有氧培养和血培养报告无菌。抗酸杆菌(AFB)染色未检出抗酸杆菌,核酸检测(CBNAAT)报告结核分枝杆菌阴性。菌株对甲硝唑(MIC = 3 μg/ml)敏感,对克林霉素(MIC = 256 μg/ml)耐药。鉴于厌氧菌抗菌药物耐药性呈上升趋势,建议对临床疑似胸膜肺感染病例进行厌氧菌培养和敏感性试验,以便正确诊断和优化患者管理。对于经验性治疗,应谨慎使用克林霉素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unilateral complicated pleural empyema in a patient with bronchial asthma due to clindamycin-resistant Prevotella buccae.

Prevotella buccae (P. buccae) is a gram-negative obligate anaerobe mainly associated with infections of odontogenic origin. Non-oral monomicrobial infection by these obligate anaerobic bacteria is rare. Only a few cases of monomicrobial non-oral infections by P. buccae have been reported in the literature. We are reporting a case of unilateral complicated pleural empyema in a patient with bronchial asthma infected by P. buccae. Pleural fluid aerobic culture and blood culture reports were sterile. No acid-fast bacilli were detected by Acid Fast Bacilli (AFB) staining, and cartridge-based nucleic acid assay test (CBNAAT) reports were negative for Mycobacterium tuberculosis. The isolate, P. buccae was found susceptible to Metronidazole (MIC = 3 μg/ml) and resistant to Clindamycin (MIC = 256 μg/ml). In view of rising trends of antimicrobial resistance among anaerobes, it is recommended to perform anaerobic culture and sensitivity testing in clinically suspected cases of pleuropulmonary infection for appropriate diagnosis and optimal patient management. Clindamycin should be used with caution for empiric treatment.

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