背景:塔达爱德华氏菌(E.tarda)是一种革兰氏阴性兼性厌氧菌,属于肠杆菌,通常从鱼类和爬行动物中分离出来。由E.tarda引起的感染在人类中并不常见,报告的人体滞留率为0.001%。它可以在老年人或患有肝功能衰竭等预先存在的疾病的人中引起败血症,自身免疫性疾病,或者恶性肿瘤。E.tarda对许多抗生素敏感;然而,据报道,脓毒症患者的死亡率较高(约40%).
方法:一名65岁女性主诉发热和腹痛到我院就诊2天。她的血液检查显示炎症标志物升高,和对比增强计算机断层扫描显示胆囊扩张和壁增厚以及胆囊周围脂肪炎症。随后,诊断为胆囊炎伴全身炎症反应综合征。开始抗菌治疗后进行腹腔镜胆囊切除术。入院时获得的血液培养物E.tarda阳性,在胆汁培养物中也检测到。因此,她被诊断为由E.tarda引起的菌血症,术后抗菌治疗继续进行.患者好转,而且没有并发症.
结论:我们经历了一例极为罕见的由塔达氏弧菌引起的急性胆囊炎。只有少数病例报道了由于E.tarda引起的急性胆囊炎。此外,类似于这种情况,以前没有研究报道在急性胆囊炎病例的血液和胆汁培养物中检测到E.tarda。除了适当的手术干预,根据培养结果连续使用抗生素可获得良好的结果.
BACKGROUND: Edwardsiella tarda (E. tarda) is a Gram-negative facultative anaerobe belonging to Enterobacteriales and is commonly isolated from fishes and reptiles. Infection due to E. tarda is uncommon among humans, with a reported human retention rate of 0.001%. It can cause sepsis in the elderly or those with pre-existing conditions such as liver failure, autoimmune disease, or malignancy. E. tarda is susceptible to many antibiotics; however, a high mortality rate (approximately 40%) has been reported with sepsis.
METHODS: A 65-year-old woman presented to our hospital with a chief complaint of fever and abdominal pain for 2 days. Her blood tests showed elevated inflammatory markers, and contrast-enhanced computed tomography showed distention and wall thickening of the gallbladder and inflammation of peri-gallbladder fat. Subsequently, a diagnosis of cholecystitis with systemic inflammatory response syndrome was made. Laparoscopic cholecystectomy was performed after starting antimicrobial therapy. Blood culture of samples obtained on admission were positive for E. tarda, which was also detected in bile juice culture. Therefore, she was diagnosed with bacteremia caused by E. tarda, and postoperative antimicrobial therapy was continued. The patient improved, and there were no complications.
CONCLUSIONS: We experienced an extremely rare case of acute cholecystitis caused by E. tarda. Only a few cases of acute cholecystitis due to E. tarda have been reported. Furthermore, similar to this case, no previous study has reported the detection of E. tarda in both blood and bile cultures in acute cholecystitis cases. In addition to appropriate surgical intervention, continuous administration of antibiotics based on culture results resulted in a favorable outcome.