一名因呼吸暂停而转诊的婴儿因混合感染拉菲诺斯肠球菌和大肠埃希菌而引发急性局灶性细菌性肾炎。

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Yuna Kamioka, Kensuke Izumida, Eiji Ohtaka, Yoshiaki Hashimoto, Hajime Okada, Hidehiko Narazaki, Yasuhiko Itoh
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引用次数: 0

摘要

一名出生 38 天的婴儿因呼吸暂停、发烧和脓尿转诊至我院。由于出现呼吸暂停,怀疑是侵入性细菌感染,包括脑膜炎。造影剂增强 CT 扫描发现了急性局部细菌性肾炎,排除了脑膜炎的可能。从转诊医院的尿液培养中分离出了革兰氏阳性球菌和革兰氏阴性杆菌,即拉菲诺斯肠球菌和大肠埃希菌。本病例报告描述了最年轻的拉菲诺斯肠球菌感染病例。呼吸暂停是主诉,但发烧的原因是婴儿急性局灶性细菌性肾炎(AFBN)混合感染。在婴儿中,细菌感染,尤其是侵袭性细菌感染可能导致不良后果,需要仔细评估和治疗。此外,AFBN 的可能性也不容忽视,因为细菌尿或白细胞尿可能并不存在,而且如果抗菌药物用药时间不足,细菌尿或白细胞尿可能会复发。虽然我们的患者对氨苄西林敏感的拉菲诺斯大肠杆菌感染治疗反应良好,但也有关于耐万古霉素肠球菌的报道,这凸显了正确使用抗菌药物以避免产生耐药菌的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute focal bacterial nephritis in an infant referred with apnea caused by mixed infection with Enterococcus raffinosus and Escherichia coli.

A 38-day-old infant was referred to our hospital for evaluation of apnea, fever, and pyuria. Invasive bacterial infection, including meningitis, was suspected because of the presence of apnea. A contrast-enhanced CT scan revealed acute localized bacterial nephritis, and meningitis was ruled out. Gram-positive cocci and Gram-negative rods, ie, Enterococcus raffinosus and Escherichia coli, were isolated from a urine culture at the referring hospital. This case report describes the youngest case of E. raffinosus infection. Apnea was the main complaint, but the origin of fever was infant acute focal bacterial nephritis (AFBN) with mixed infection. In infants, bacterial infections, especially invasive bacterial infections, can result in poor outcomes and require careful evaluation and treatment. Furthermore, the possibility of AFBN should not be overlooked, because bacteriuria or leukocyturia may be absent and can flare up if antimicrobials are not administered for an adequate duration. Although ampicillin-susceptible E. raffinosus infection in our patient responded well to treatment, there have been reports of vancomycin-resistant enterococci, which highlights the importance of proper use of antimicrobial agents to avoid producing drug-resistant bacteria.

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来源期刊
Journal of Nippon Medical School
Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
10.00%
发文量
118
期刊介绍: The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.
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