背景:塔达爱德华氏菌(E.tarda)是革兰氏阴性兼性厌氧细菌。胃肠炎是塔田大肠杆菌感染的最常见表现。然而,肠外感染可发生在免疫缺陷的宿主,以及肝胆疾病,恶性肿瘤,和/或糖尿病。由E.tarda引起的败血症的预后非常差,死亡率为38%。我们报告了急性胆囊炎合并感染性休克和E.tarda血流感染的发生。
方法:一名64岁男性因乙肝病毒感染继发急性胆囊炎,表现为发热和突发性上腹痛。抵达后,右上腹痛,恶心,呕吐,发烧,观察到黄疸。计算机断层扫描显示胆总管结石和胆囊结石。胆总管结石合并急性胆管炎的诊断和手术治疗。由于感染性休克,对血液培养物进行评估,显示以E.tarda为主要病原体.胆总管切开取石术,T型管引流,胆囊切除术,术后静脉注射抗生素治疗。手术后病人顺利康复。
结论:虽然塔达大肠杆菌感染极为罕见,它会导致快速进展和危及生命的疾病的快速发作,以及肠道和肠胃外感染。如有必要,应考虑早期手术治疗肠外感染,并应及时使用抗生素。
BACKGROUND: Edwardsiella tarda (E. tarda) is a gram-negative facultative anaerobic bacterium. Gastroenteritis is the most common manifestation of E. tarda infection. However, parenteral infections can occur in immunodeficient hosts, as well as hepatobiliary diseases, malignancies, and/or diabetes. The prognosis of sepsis caused by E. tarda is very worse, with a mortality rate of 38%. We report the occurrence of acute cholecystitis with septic shock and E. tarda bloodstream infection.
METHODS: A 64-year-old male with acute cholecystitis secondary to hepatitis B virus infection showed fever and sudden upper abdominal pain. On arrival, right upper abdominal pain, nausea, vomiting, fever, and jaundice were observed. Computed tomography showed common bile duct stones and gallbladder stones. Choledocholithiasis with acute cholangitis was diagnosed and treated surgically. Due to septic shock, a blood culture was assessed showing E. tarda as the main pathogen. Choledocholithotomy, T-tube drainage, cholecystectomy, and intravenous antibiotic treatment after the operation. The patient recovered smoothly after the operation.
CONCLUSIONS: Although E. tarda infection is extremely rare, it can cause rapid episodes of rapidly progressive and life-threatening disease, as well as intestinal and parenteral infections. If necessary, early surgical treatment of parenteral infection should be considered and antibiotics should be used in time.