口腔健康不良和新冠肺炎感染的免疫功能正常患者的致脓性肝脓肿。

Manuel Vazquez, Alana Vassil, Igor Sirotkin
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引用次数: 0

摘要

背景:化脓性肝脓肿(PHA)是由肝实质细菌感染引起的肝脏脓液聚集。PHA在免疫抑制个体和糖尿病、癌症和肝移植患者中更常见。病例介绍:我们报告了一例罕见的有核梭杆菌PHA病例,患者具有免疫功能,口腔健康不良,有乳头炎病史,最近感染了新冠肺炎,其唯一症状是胸痛和4周的发烧和不适史。该患者的感染源可能是龋齿和牙周病,新冠肺炎感染在该患者的疾病进展中起到转移注意力的作用,从而推迟了诊断。结论:PHA的诊断和治疗必须及时进行引流和经验性厌氧覆盖,如果通过培养指示,则采用更具针对性的抗生素方案,如果通过计算机断层扫描指示,则进一步引流。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pyogenic Hepatic Abscess in an Immunocompetent Patient With Poor Oral Health and COVID-19 Infection.

Background: Pyogenic hepatic abscess (PHA) is a collection of pus in the liver caused by bacterial infection of the liver parenchyma. PHA is more common in immunosuppressed individuals and those with diabetes mellitus, cancer, and liver transplant.

Case presentation: We present a rare case of PHA with Fusobacterium nucleatum in an immunocompetent patient with poor oral health, history of diverticulitis, and recent COVID-19 infection whose only symptoms were chest pain and a 4-week history of fever and malaise. The source of infection in this patient was likely dental caries and periodontal disease, with COVID-19 infection playing a role as a red herring in this patient's disease progression, delaying diagnosis.

Conclusions: Diagnosis and treatment of PHA must be prompt with drainage and empiric anaerobic coverage followed by a more tailored antibiotic regimen if indicated by culture and further drainage if indicated by computed tomography.

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