PDF(Pubmed)
Abstract：
We report a case of a woman with diabetes mellitus and choledocholithiasis who had a low fever with chills and severe weakness for 7 days. The patient\'s abdominal tenderness was positive. Computed tomography and magnetic resonance imaging showed a giant abscess in the liver. The production of extended-spectrum β-lactamases by hypervirulent Klebsiella pneumoniae was found in the purulent fluid of the liver by nanopore-based metagenomic third-generation sequencing combined with an antibiotic susceptibility test. The patient recovered after intravenous antibiotic therapy and percutaneous drainage. Patients with a history of diabetes mellitus and choledocholithiasis should be aware of the possibility of pyogenic liver abscesses caused by hypervirulent Klebsiella pneumoniae. To rapidly control the development of this disease, nanopore-based metagenomic third-generation sequencing plays an important role not only in rapidly identifying pathogens, but also in guiding the use of antibiotics.
摘要：
我们报告了一例患有糖尿病和胆总管结石症的妇女，她低烧，发冷，严重虚弱7天。患者腹部压痛呈阳性。计算机断层扫描和磁共振成像显示肝脏中有一个巨大的脓肿。通过基于纳米孔的宏基因组第三代测序结合抗生素敏感性试验，在肝脏的化脓液中发现了高毒力肺炎克雷伯菌产生的超广谱β-内酰胺酶。患者经静脉抗生素治疗和经皮引流后康复。有糖尿病和胆总管结石病史的患者应意识到由高毒力肺炎克雷伯菌引起的化脓性肝脓肿的可能性。为了迅速控制这种疾病的发展，基于纳米孔的宏基因组第三代测序不仅在快速识别病原体、还可以指导抗生素的使用。
