PDF(Pubmed)
Abstract：
This report describes a patient with Pasteurella multocida pneumonia. The patient was a man in his 70s with significant comorbid conditions, including chronic obstructive pulmonary disease (COPD), and is an example of the diverse presentations of P. multocida infections increasingly found in the literature. The novelty of this case lies in the manifestation of P. multocida pneumonia in a patient with underlying respiratory conditions and its successful management, outlining a unique clinical scenario and a tailored therapeutic approach. A 71-year-old male with a medical history of COPD, asthma, tremors, hypertension, and arthritis presented to the emergency department with progressive shortness of breath, productive cough, and chest tightness. The initial diagnosis was COPD exacerbation and left lower lobe pneumonia, for which a regimen of ceftriaxone and azithromycin was initiated. The patient\'s condition was further complicated by the persistence of symptoms. Following sputum culture analysis, P. multocida infection was identified. Consequently, the antibiotic regimen was tailored, transitioning the patient to doxycycline, which led to substantial clinical improvement, enabling discharge with a 10-day course of oral doxycycline. This case elucidates the importance of precise microbiological diagnosis in patients with complex respiratory conditions, as it guides more targeted antibiotic therapy. It highlights the need for clinical vigilance for atypical pathogens like P. multocida in patients with COPD exacerbations, especially when conventional treatment strategies yield suboptimal responses. The successful resolution of the pneumonia underscores the effectiveness of antibiotic stewardship guided by sputum culture findings.
摘要：
本报告描述了一名多杀性巴氏杆菌肺炎患者。病人是一名70多岁的男子，患有严重的合并症，包括慢性阻塞性肺疾病（COPD），并且是文献中越来越多地发现的多杀性疟原虫感染的多样化表现的一个例子。这种情况的新颖之处在于，在患有潜在呼吸道疾病的患者中表现出多性疟原虫肺炎及其成功的治疗，概述了独特的临床方案和量身定制的治疗方法。一名71岁男性，有COPD病史，哮喘,震颤,高血压,和关节炎出现在急诊科，伴有进行性呼吸急促，生产性咳嗽,和胸闷。最初诊断为COPD加重和左下叶肺炎，为此开始了头孢曲松和阿奇霉素的治疗方案。患者的病情因症状的持续而进一步复杂化。痰培养分析后，鉴定了多杀性疟原虫感染。因此,抗生素治疗方案是量身定制的，让病人转用多西环素,这导致了临床上的实质性改善，通过口服多西环素10天的疗程使出院。该病例阐明了对复杂呼吸系统疾病患者进行精确微生物学诊断的重要性,因为它指导更有针对性的抗生素治疗。它强调需要临床警惕非典型病原体，如多杀性疟原虫在COPD急性加重患者中，特别是当常规治疗策略产生次优反应时。肺炎的成功解决强调了以痰培养结果为指导的抗生素管理的有效性。
