Salmonella

沙门氏菌
  • 文章类型: Case Reports
    爬行动物通常是沙门氏菌的无症状携带者,在成年和非免疫功能低下的动物中,急性形式的典型临床体征的表现被认为是例外。在目前的情况下,一只成年雄性玉米蛇(Pantherophisguttatus)在食用在线购买的饲养小鼠48小时后,因感染性休克而死亡。培养蛇的组织样品和粪便以进行细菌分离。蛇和小鼠肝脏的微生物学检查显示存在肠沙门氏菌亚种。肠道血清型中途。对这两个分离株的全基因组分析表明,它们之间存在高度相关性:对于经典MLST方案,它们属于ST-357型菌株,对于cgMLST方案,它们属于ST171322型菌株。此外,毒力基因分析显示存在stdB和STM3026基因。这份报告传达了一例宠物蛇的食源性沙门氏菌病,从喂食鼠标传输,可能是蛇因感染性休克而死亡的原因。它强调了饲养小鼠作为蛇中沙门氏菌感染来源的相关性以及对人类健康的相关风险。
    Reptiles are usually asymptomatic carriers of Salmonella, with the manifestation of typical clinical signs of acute forms in adult and non-immunocompromised animals being considered exceptions. In the present case, an adult male corn snake (Pantherophis guttatus) was found dead due to septic shock 48 h after consuming a feeder mouse purchased online. The snake\'s tissue samples and faeces were cultured for bacteria isolation. Microbiological examinations of the snake and mouse livers revealed the presence of Salmonella enterica subsp. enterica serovar Midway. A whole-genome analysis of these two isolates showed a high correlation between them: they belonged to the strain type ST-357 for the classic MLST scheme and to the strain type ST 171322 for the cgMLST scheme. Also, a virulence gene analysis revealed the presence of stdB and STM3026 genes. This report conveys a case of food-borne salmonellosis in a pet snake, transmitted from a feeder mouse, likely responsible for the snake\'s death due to septic shock. It highlights the relevance of feeder mice as a source of Salmonella infections in snakes and the associated risks to human health.
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  • 文章类型: Case Reports
    伤寒沙门氏菌(S.伤寒)感染通常伴有发烧和胃肠道症状。此例伤寒沙门氏菌肠炎的报告记录了不典型的临床,放射学,和内窥镜检查结果提出了诊断挑战。沙特阿拉伯王国(KSA)一名31岁的男性出现严重的腹痛,呕吐,血性腹泻,没有发烧。最初诊断包括阿米巴病和其他胃肠炎感染。尽管用环丙沙星和甲硝唑治疗,病人的情况没有好转,他一直有顽固性腹痛和呕吐。随后的调查,包括腹部超声和食管胃十二指肠镜检查,显示广泛和快速进展的肠道炎症,壁增厚和腹水。粪便培养最终鉴定出一种多重耐药的伤寒沙门氏菌,只对头孢曲松敏感.头孢曲松治疗和持续输注质子泵抑制剂(PPI)导致显着改善。在血性腹泻的情况下没有发烧,和腹水的快速发展没有改善与胃肠炎的一线治疗,导致寻找其他诊断,如炎症性肠综合征或肺结核。表现为弥漫性肠壁增厚伴顽固性呕吐,血性腹泻,并且逐渐增加的腹水不经常遇到伤寒沙门氏菌。该病例还强调了抗生素抗性伤寒沙门氏菌菌株的日益关注。患者对靶向抗生素治疗的反应强调了准确的微生物鉴定和药敏试验在管理感染性疾病中的重要性。该病例报告说明了伤寒沙门氏菌肠炎的非典型表现,腹水逐渐增加,肠壁增厚增加。罕见的复杂临床表现导致诊断和管理方面的挑战。它强调在常见感染的非典型病例中需要高度临床怀疑和全面的诊断方法,特别是在抗生素耐药性增加的情况下。
    Salmonella typhi (S. typhi) infections typically present with fever and gastrointestinal symptoms. This case report on S. typhi enteritis documents atypical clinical, radiological, and endoscopic findings raising diagnostic challenges. A 31-year-old male in the Kingdom of Saudi Arabia (KSA) presented with severe abdominal pain, vomiting, bloody diarrhea, and no fever. Initial diagnosis included amebiasis and other gastroenteritis infections. Despite treatment with ciprofloxacin and metronidazole, the patient\'s condition did not improve, and he kept having intractable abdominal pain and vomiting. Subsequent investigations, including abdominal ultrasound and esophagogastroduodenoscopy, revealed extensive and rapidly progressive intestinal inflammation with wall thickening and ascites. Stool culture eventually identified a multidrug-resistant strain of S. typhi, sensitive only to ceftriaxone. Treatment with ceftriaxone and continuous infusion of proton pump inhibitor (PPI) led to significant improvement. The absence of fever in the context of bloody diarrhea, and the rapid development of ascites not improving with first-line treatment of gastroenteritis, led to the search for other diagnoses such as inflammatory bowel syndromes or tuberculosis. The presentation of diffuse intestinal wall thickening with intractable vomiting, bloody diarrhea, and progressively increasing ascites is not frequently encountered with S. typhi. The case also underscores the growing concern of antibiotic-resistant S. typhi strains. The patient\'s response to targeted antibiotic therapy emphasizes the importance of accurate microbial identification and susceptibility testing in managing infectious diseases. This case report illustrates an atypical presentation of S. typhi enteritis with progressively increasing ascites and increased intestinal wall thickening. The uncommon complicated clinical picture led to challenges in diagnosis and management. It emphasizes the need for high clinical suspicion and comprehensive diagnostic approaches in atypical cases of common infections, especially in the context of increasing antibiotic resistance.
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  • 文章类型: Journal Article
    据估计,沙门氏菌是美国国内获得的食源性疾病的主要细菌原因。近年来,据报道,由于碎牛肉引起的沙门氏菌大规模爆发。与这些疫情有关的感染者的人口统计学和社会人口学特征知之甚少。我们采用回顾性病例对照设计;病例患者是2012-2019年间实验室确诊的沙门氏菌感染与碎牛肉相关的暴发,对照组是2018-2019年FoodNet人口调查的受访者,他们报告吃了碎牛肉,否认最近的胃肠道疾病。我们使用县级CDC/ATSDR社会脆弱性指数(SVI)来比较病例和对照。病例-患者状况根据县级社会脆弱性和个人层面的人口统计学特征进行回归。我们在FoodNet网站中确定了376名病例患者和1,321名对照。当根据个人水平调整时,作为病例患者与县级社会脆弱性(OR:1.21[95%CI:1.07-1.36])和社会经济脆弱性(OR:1.24[1.05-1.47])增加相关。病例-患者状态与家庭组成和残疾的其他SVI主题没有强烈关联,少数民族地位和语言,以及住房类型和运输。关于个人层面因素的数据,如收入,贫穷,失业,教育可以促进进一步的分析来理解这种关系。
    Salmonella is estimated to be the leading bacterial cause of U.S. domestically acquired foodborne illness. Large outbreaks of Salmonella attributed to ground beef have been reported in recent years. The demographic and sociodemographic characteristics of infected individuals linked to these outbreaks are poorly understood. We employed a retrospective case-control design; case-patients were people with laboratory-confirmed Salmonella infections linked to ground beef-associated outbreaks between 2012 and 2019, and controls were respondents to the 2018-2019 FoodNet Population Survey who reported eating ground beef and denied recent gastrointestinal illness. We used county-level CDC/ATSDR Social Vulnerability Index (SVI) to compare case-patient and controls. Case-patient status was regressed on county-level social vulnerability and individual-level demographic characteristics. We identified 376 case-patients and 1,321 controls in the FoodNet sites. Being a case-patient was associated with increased overall county-level social vulnerability (OR: 1.21 [95% CI: 1.07-1.36]) and socioeconomic vulnerability (OR: 1.24 [1.05-1.47]) when adjusted for individual-level demographics. Case-patient status was not strongly associated with the other SVI themes of household composition and disability, minority status and language, and housing type and transportation. Data on individual-level factors such as income, poverty, unemployment, and education could facilitate further analyses to understand this relationship.
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  • 文章类型: Case Reports
    我们报告了一名43岁女性患者的化脓性关节炎病例。尽管根据血液和关节液培养结果,最初用头孢曲松治疗非伤寒沙门氏菌,肩关节疼痛加重。疑似系统性红斑狼疮相关滑膜炎对包括甲基强的松龙在内的免疫抑制治疗没有反应,羟氯喹和甲氨蝶呤。随后的X光片显示肩关节脓肿,导致关节镜下关节清创术。术后给予头孢曲松直至达到镇痛效果。此病例强调了非伤寒沙门氏菌化脓性关节炎的准确诊断和适当治疗的重要性。
    We report a case of septic arthritis in a 43-year-old female patient. Despite initial treatment with ceftriaxone for Nontyphoidal Salmonella based on blood and joint fluid culture results, the shoulder joint pain worsened. Suspected systemic lupus erythematosus associated synovitis did not respond to immunosuppressive therapy including methylprednisolone, hydroxychloroquine and methotrexate. Subsequent radiograph revealed a shoulder joint abscess, leading to arthroscopic joint debridement. Ceftriaxone was administered post-operatively until analgesic efficacy was attained. This case highlights the significance of accurate diagnosis and appropriate treatment for nontyphoidal Salmonella septic arthritis.
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  • 文章类型: Case Reports
    背景:沙门氏菌为革兰氏阴性,兼性厌氧肠杆菌科细菌由两个物种组成,肠沙门氏菌和邦戈里沙门氏菌。侵袭性疾病,比如脑膜炎,导致住院,短期和长期并发症,和高死亡率。
    方法:一名4个月大的女婴因腹泻和发热入院。白细胞计数,尿液分析,尿液培养物,粪便培养正常。她用头孢呋辛静脉注射治疗5天。她口服头孢丙齐出院5天。治疗结束后,她因发烧再次住进了同一家医院,腹泻,呕吐物,和怪癖。脑脊液检查显示细胞增多,而S.enterica被隔离。头孢曲松治疗,阿米卡星,和地塞米松开始。因为颅内高压的迹象,她被转移到我们三级医院的儿科重症监护室。继续静脉注射头孢曲松治疗。脑MRI显示蛛网膜下腔扩张。头围的增加和脉冲状的fontanel导致了新的脑MRI,其中注意到心室扩张和实质外硬膜下收集。将头孢曲松改为头孢噻肟,并加入环丙沙星。她的临床状况很好;她的脑部MRI,一周后,显着改善,并完成了为期5周的静脉抗生素疗程。她的基线免疫缺陷筛查测试正常,停止治疗后两个月重复MRI未发现先前的异常。
    结论:侵袭性沙门氏菌病,比如脑膜炎,在当今的工业国家中很少见,优化管理尚未建立。沙门氏菌脑膜炎的晚期并发症需要更彻底的神经发育随访。
    BACKGROUND: Salmonellae are gram-negative, facultatively anaerobic Enterobacteri-aceae consisting of two species, Salmonella enterica and Salmonella bongori. Invasive diseases, such as meningitis, result in hospitalization, short and long-term complications, and high mortality rates.
    METHODS: A 4-month-old baby girl was admitted to a district hospital because of diarrhea and fever. WBC count, urinalysis, urine cultures, and stool cultures were normal. She was treated with intravenous cefuroxime for 5 days. She was discharged on oral cefprozil for 5 days. After the end of therapy, she was admitted again to the same hospital with fever, diarrhea, vomits, and irri-tability. Cerebrospinal fluid examination revealed pleocytosis, while S. enterica was isolated. Em-pirical therapy with ceftriaxone, amikacin, and dexamethasone was started. Because of intracranial hypertension signs, she was transferred to the pediatric intensive care unit of our tertiary hospital. Therapy continued with intravenous ceftriaxone. Brain MRI revealed subarachnoid space dilata-tion. Increased head circumference and pulsating bregmatic fontanel led to a new cerebral MRI, in which ventricular dilatation and extraparenchymal subdural collection were noted. Ceftriaxone was changed to cefotaxime and ciprofloxacin was added. She remained clinically well; her brain MRI, a week later, showed marked improvement, and the course of intravenous antibiotics for 5 weeks was completed. Her baseline immunodeficiency screening tests were normal and repeat MRI two months post-treatment cessation did not reveal the previous abnormalities.
    CONCLUSIONS: Invasive Salmonella diseases, such as meningitis, are very uncommon in industrial countries nowadays, and the optimal management is yet not well established. Late onset of com-plications from Salmonella meningitis warrants more thorough neurodevelopmental follow-ups.
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  • 文章类型: Case Reports
    由肠沙门氏菌引起的脑膜炎可能是一种致命的疾病,在低收入和中等收入国家更常见,在婴儿中并不常见。这例2个月大男婴报告沙门菌脑膜炎症状,比如发烧,烦躁,改变的感官,和腹泻。临床检查显示前fontanelles膨出,脱水,和凹陷的眼睛。听力正常筛查,头颅超声,磁共振成像(MRI)显示没有脑部异常。脑脊液(CSF)培养显示革兰氏阴性沙门氏菌。抗生素药敏试验显示敏感性后,开始使用美罗培南和氨苄西林治疗。抗生素治疗后,患者的脑脊液参数和细菌生长得到改善。两周后,婴儿神经健康,出院。儿科医生应该意识到,肠道沙门氏菌可导致具有非特异性症状的儿童脑膜炎。
    Meningitis caused by Salmonella enterica can be a fatal condition that is more common in low- and middle-income countries and uncommon in infants. This case of a 2-month-old male infant reported Salmonella meningitis symptoms, such as fever, irritability, altered sensorium, and diarrhoea. Clinical examination revealed bulging anterior fontanelles, dehydration, and sunken eyes. Screening for normal hearing, cranial ultrasound, and magnetic resonance imaging (MRI) revealed no brain abnormalities. A cerebrospinal fluid (CSF) culture revealed gram-negative Salmonella enterica bacilli. Treatment with meropenem and ampicillin was initiated after antibiotic susceptibility testing showed sensitivity. The patient\'s cerebrospinal fluid parameters and bacterial growth improved after antibiotic therapy. Two weeks later, the baby was neurologically healthy and discharged. Paediatricians should be aware that Salmonella enterica can cause meningitis in children with non-specific symptoms.
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  • 文章类型: Case Reports
    子宫内膜炎的微生物学诊断和基于抗菌谱的适当抗生素治疗至关重要。我们应该对潜在的病原体保持批评,尤其是在国外旅行和怀孕期间。因此,在使用抗生素之前获得培养物是必不可少的。
    我们介绍了一例不完全性流产患者术后子宫内膜炎,接受扩张和刮宫的人。血,宫颈和粪便培养显示存在沙门氏菌hvittingfoss。妇科术后感染沙门氏菌。根据目前的文献,这是罕见的。
    UNASSIGNED: Microbiological diagnosis of endometritis and appropriate antibiotic treatment based on the antibiogram is essential. We should remain critical about the potential etiologic pathogens, especially when traveling abroad and during pregnancy. Therefore, it is essential to obtain cultures prior to the administration of antibiotics.
    UNASSIGNED: We present a case of postoperative endometritis in a patient with incomplete miscarriage, who underwent dilatation and curettage. Blood, cervical and stool cultures revealed the presence of Salmonella hvittingfoss. Gynecological postoperative infections with Salmonella spp. are rare according to the current literature.
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  • 文章类型: Case Reports
    报告1例免疫功能低下的早产儿和1例免疫功能正常的成年人中2例沙门氏菌内源性眼内炎的罕见病例,并对相关病例进行简要文献复习。只有在病原体从眼部样本中生长出来后,才确认了这两种情况下的诊断。在没有明显的肠道发热迹象的情况下。
    医学和微生物学记录的回顾性分析。
    我们的两例沙门氏菌眼内炎的视力都不好,尽管及时积极的管理,无论患者的免疫状态如何。最初没有怀疑沙门氏菌感染是眼内炎的罕见原因,因为成年人在出现前2周有轻微的全身症状。而早产儿仍在吃牛奶。在过去的10年中,这只是我们研究所的两例沙门氏菌眼内炎的微生物学确诊病例,尽管沙门氏菌引起的肠热在亚洲国家是地方性的。
    沙门氏菌眼内炎,虽然罕见,尽管早期识别和积极管理,但仍导致不良的视觉结果,并且可能与其他感染或非感染性实体(如婴儿坏死性视网膜母细胞瘤)相混淆,在没有明确的全身性疾病体征的情况下。
    UNASSIGNED: To report two rare cases of Salmonella endogenous endophthalmitis in an immunocompromised premature baby and an immunocompetent adult and do a brief literature review of related cases. Diagnosis in both cases was confirmed only after the pathogen grew from ocular samples, in the absence of clear signs of enteric fever.
    UNASSIGNED: Retrospective analysis of medical and microbiology records.
    UNASSIGNED: Both of our cases of Salmonella endophthalmitis had poor visual outcome, despite timely and aggressive management and irrespective of immune status of the patient. Salmonella infection being a rare cause of endophthalmitis was not initially suspected as the adult had minimal systemic symptoms 2 weeks before presentation, while the preterm baby was still on milk feeds. These were just two microbiologically confirmed cases of Salmonella endophthalmitis at our institute over the past 10 years, though enteric fever due to Salmonella species is endemic in Asian countries.
    UNASSIGNED: Salmonella endophthalmitis, though rare, leads to poor visual outcomes despite early recognition and aggressive management and may be confused with other infections or non-infectious entities such as necrotizing retinoblastoma in babies, in the absence of clear systemic signs of the disease.
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  • 文章类型: Case Reports
    在这个案例报告中,我们描述了一例罕见的非伤寒沙门氏菌菌血症病例,该病例发生在一名87岁女性中,无明显的每日沙门氏菌暴露史.病人出现发烧,身体不适,和腹泻。体检排除了沙门氏菌的常规来源,包括生食消费和宠物接触。她的病史包括术后乙状结肠癌,左乳腺癌,和其他疾病。尽管沙门氏菌感染通常源于口服,这种情况表明胃肠道的细菌易位可能是主要原因,患者的年龄和病史可能会加剧。另一个假设是从腹泻到泌尿道的上升感染,这可能导致肾盂肾炎和随后的菌血症。该病例强调了认识到在表现出不同症状的老年个体中发生严重感染如败血症的可能性的重要性。因此,此案进一步强调了提高临床警惕性的必要性,尤其是在社区医院,确保及时和适当地管理老年人口的这种严重状况。
    In this case report, we describe a rare case of non-typhoidal Salmonella bacteremia in an 87-year-old woman with no apparent history of daily Salmonella exposure. The patient presented with fever, body discomfort, and diarrhea. Medical examinations ruled out usual sources of Salmonella, including raw food consumption and pet contact. Her medical history included postoperative sigmoid colon cancer, left breast cancer, and other ailments. Although Salmonella infection typically stems from oral intake, this case suggests that bacterial translocation from the gastrointestinal tract could be the primary cause, potentially exacerbated by the patient\'s age and medical history. Another hypothesis is an ascending infection from diarrhea to the urinary tract, which might have led to pyelonephritis and subsequent bacteremia. This case highlights the importance of recognizing the potential for severe infections such as sepsis in older individuals presenting with diverse symptoms. Therefore, this case further underscores the need for heightened clinical vigilance, especially in community hospitals, to ensure timely and appropriate management of such severe conditions in the older population.
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  • 文章类型: Case Reports
    Non-typhoidal Salmonella infections (NTSI) can cause bacterial diarrhea, mostly leading to self-limiting gastroenteritis. However, in at-risk populations, NTSI can have severe complications. As transmission is most commonly foodborne, infection is rare in the breast- or bottle-fed very young. Another route is increasingly implicated, however, in newborns and infants especially: Contact with reptiles and amphibians. We describe infection with Salmonella enterica subsp. enterica ser. Monschaui (S. Monschaui), transmitted from bearded dragons, in a three-week-old boy. The boy initially appeared well, on the next morning deterioration was dramatic, with tachypnea, tachycardia, and mottled skin. Gram-negative sepsis was documented on day 2. His case prompted a review of published instances of reptile- and amphibian-associated salmonellosis (RAAS), summarized here. Association of S. Monschaui infection with exposure to reptiles and amphibians prompted inquiry into household pets. The parents had kept bearded dragons (Pogona sp.), the last of which died two weeks before the patient was born; confirmation of colonization with S. Monschaui was thus precluded. Among 63 reports (-5,000 cases) of RAAS or S. Monschaui, 62 appeared between 1995 and 2022, 10 were single case reports, and 53 were original articles with -5,000 cases; vectors included turtles, frogs, lizards, and snakes. RAAS is not a new phenomenon, but its incidence recently has risen due to the increased popularity of reptiles and amphibians as non-traditional pets. These animals can carry Salmonella sp. and transmit it to humans, posing a risk particularly to infants and other vulnerable persons. Risk mitigation requires that those bringing such pets into the home be informed of dangers associated with reptile and amphibian contact; that those selling reptiles and amphibians be mandated to inform customers comprehensively may be in order.
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