septic pulmonary embolism

脓毒性肺栓塞
  • 文章类型: Case Reports
    败血症性肺栓塞(SPE)代表循环中败血症性血栓的发生,源自肺外感染源.肛周和直肠周围脓肿是经常遇到的肛门直肠问题,通常源于肛门隐窝腺体阻塞,导致脓液在皮下组织和括约肌间平面内积聚。及时的手术引流对肛门直肠脓肿的诊断至关重要。与女性相比,成年男性肛门直肠脓肿和瘘管的发病率高两倍,常见症状包括肛门或直肠疼痛。该病例报告详细介绍了一名42岁男性患者的表现和治疗,该患者患有肺炎克雷伯菌肛周脓肿,导致SPE。该报告强调了及时识别和治疗肛门直肠脓肿的重要性,以避免可能危及生命的并发症,例如败血症和瘘管。
    Septic pulmonary embolism (SPE) represents the occurrence of septic thrombi in circulation, originating from an extrapulmonary infectious source. Perianal and perirectal abscesses are frequently encountered anorectal issues, often stemming from obstructed anal crypt glands, resulting in pus accumulation within the subcutaneous tissue and intersphincteric plane. Timely surgical drainage is essential upon diagnosis of anorectal abscesses. Adult males exhibit a twofold higher incidence of anorectal abscesses and fistulae compared to females, with common symptoms including excruciating anal or rectal pain. This case report details the presentation and management of a 42-year-old male patient afflicted by Klebsiella pneumonia perianal abscesses that led to SPE. The report underscores the importance of recognizing and treating anorectal abscesses promptly to avert potentially life-threatening complications such as sepsis and fistulae.
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  • 文章类型: Case Reports
    脓毒性肺栓塞(SPE)可能起源于不寻常的来源,例如小沸腾,有必要考虑呼吸窘迫的不同病因。及时诊断,量身定做的抗生素,和警惕的并发症管理优化结果。早期识别和治疗轻微感染,尤其是在糖尿病中至关重要。
    Septic pulmonary embolism (SPE) can originate from unusual sources like small boils, warranting consideration of diverse etiologies in respiratory distress. Prompt diagnosis, tailored antibiotics, and vigilant complication management optimize outcomes. Early recognition and treatment of minor infections, especially in diabetes are crucial.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    背景:单核细胞增生李斯特菌是一种已知引起李斯特菌病的细菌病原体,一种食源性疾病,临床表现广泛,从轻度胃肠炎到严重的侵袭性疾病,特别是影响免疫功能低下的个体,孕妇,新生儿,和老人。成功治疗因外来物质而反复发作的李斯特菌患者通常具有挑战性。通常需要抗菌治疗和手术切除的组合。
    方法:这里,我们介绍了一个特别复杂的慢性侵袭性李斯特菌病病例,总共6次复发。经过广泛的调查,患者的ICD装置被确定为感染的重点。
    结论:通过cgMLST分析对复发的确认强调了单核细胞增生李斯特菌的持久性和复发的可能性,即使在有异物的患者症状明显消退后也是如此。它强调了全面评估以确定和减轻复发风险的必要性,从而确保最佳管理和结果。
    BACKGROUND: Listeria monocytogenes is a bacterial pathogen known for causing listeriosis, a foodborne illness with a wide spectrum of clinical presentations ranging from mild gastroenteritis to severe invasive disease, particularly affecting immunocompromised individuals, pregnant women, newborns, and the elderly. Successful treatment of patients with recurring listeria episodes due to colonised foreign material is often challenging, typically requiring a combination of antimicrobial treatment and surgical removal.
    METHODS: Here, we present a particularly complex case of chronic invasive listeriosis with a total of six relapses. After extensive investigations, the patient\'s ICD device was identified as the focus of infection.
    CONCLUSIONS: The confirmation of relapses through cgMLST analysis highlights the persistence of Listeria monocytogenes and the potential for recurrence even after apparent resolution of symptoms in patients with foreign material. It emphasises the necessity for a comprehensive assessment to identify and mitigate the risk of relapses, thereby ensuring optimal management and outcomes.
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  • 文章类型: Case Reports
    Septic pulmonary embolism rarely occurs in children, displaying fairly distinctive radiological features that can, however, lead to misdiagnosis. We present a case of an Indonesian pediatric patient with an infection originating from cellulitis in his right calf, who underwent a chest X-ray followed by a CT scan. The findings from these examinations revealed characteristics consistent with septic pulmonary embolism, correlating with the growth of both gram-positive and gram-negative bacteria in microbiological cultures obtained from wound specimens, as indicated in the literature. Awareness of specific imaging features is crucial for accurately diagnosing septic pulmonary embolism in this case and initiating appropriate treatment.
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  • 文章类型: Journal Article
    非血栓性肺栓塞,一个不常见的实体,被定义为组织的栓塞,微生物,空气,或外国材料。该非血栓性类别中的一个子集是脓毒性肺栓塞(SPE),其是指具有或不具有血栓套的微生物进入肺脉管系统的栓塞。这种情况通常基于具有临床相关性的成像来识别。不幸的是,有关病理特征的数据很少。这促使在尸检时审查此类案件。
    研究尸检时SPE的病理特征。
    回顾性回顾了医院的十年(2012年至2021年)尸检记录。诊断基于急性坏死性肺动脉炎伴支气管动脉周围巩固的鉴定。这些病例是参考人口统计学进行分析的,临床特征,和肺/肺外尸检结果。
    无。
    根据纳入标准,19例显示存在SPE。有11名男性和8名女性,平均年龄为32.1岁。主要感染源包括皮肤和肌肉骨骼系统引起的感染(11例患者,59.7%)。常见的临床表现包括发热,呼吸困难,胸痛,咯血,和改变的感官。死亡原因主要是败血症和/或融合的肺巩固。在所有情况下都看到了大量的细菌菌落;在两种情况下还鉴定出念珠菌物种。其他肺部表现包括弥漫性肺泡损伤,新鲜的动脉血栓形成,梗塞,动脉假性动脉瘤,脓肿形成,化脓性胸膜炎.
    存在持续发热的肺外感染,菌血症,肺部投诉应该引起对该实体的怀疑,特别是在资源贫乏的环境中,防止严重的肺部并发症.
    UNASSIGNED: Non-thrombotic pulmonary embolism, an uncommon entity, is defined as the embolization of tissues, microorganisms, air, or foreign material. One subset in this non-thrombotic category is septic pulmonary embolism (SPE) that refers to embolism of microorganisms with or without a thrombotic mantle into the pulmonary vasculature. This condition is often recognized on the basis of imaging with a clinical correlation. Unfortunately, data regarding the pathological features are meager. This has prompted to review such cases at autopsy.
    UNASSIGNED: To study the pathological features of SPE at autopsy.
    UNASSIGNED: Ten-year (2012 to 2021) autopsy records of the hospital were retrospectively reviewed. The diagnosis was based on the identification of acute necrotizing pulmonary arteritis with peri-bronchoarterial consolidation. These cases were analyzed with reference to the demographics, clinical characteristics, and pulmonary/extrapulmonary findings at autopsy.
    UNASSIGNED: Nil.
    UNASSIGNED: According to the inclusion criterion, 19 cases demonstrated the presence of SPE. There were 11 men and 8 women with a mean age of 32.1 years. The major source of infection included infection arising from skin and musculo-skeletal system (11 patients, 59.7%). The common clinical presentation included fever, dyspnea, chest pain, hemoptysis, and altered sensorium. The cause of death was mainly due to septicemia and/or confluent lung consolidations. A large number of bacterial colonies were seen in all; Candida species were also identified in two cases. Other lung findings included diffuse alveolar damage, fresh arterial thrombosis, infarction, arterial pseudo-aneurysms, abscess formation, and pyogenic pleuritis.
    UNASSIGNED: Presence of an extrapulmonary infection with persistent fever, bacteremia, and pulmonary complaints should raise suspicion for this entity, particularly in resource-poor settings, to prevent grave pulmonary complications.
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  • 文章类型: Case Reports
    感染性心内膜炎(IE)是一种相对罕见但危及生命的疾病,具有潜在的并发症,如瓣膜功能障碍,脓肿形成,穿透性病变的发展和脓毒性物质的栓塞。在这个案例报告中,我们描述了一例56岁的IE患者,其累及三尖瓣,由于大量败血物质的栓塞,导致右肺动脉几乎完全闭塞.虽然败血物质的栓塞是有据可查的,相关的右肺动脉闭塞是罕见的。
    感染性心内膜炎(IE)是一种罕见但危及生命的疾病,具有潜在的并发症,如心脏瓣膜功能障碍,形成受感染材料的集合,心脏缺陷的发展,以及导致阻塞的受感染物质的传播。在这个案例报告中,我们描述了一例56岁的IE患者涉及其中一个心脏瓣膜,由于大块感染物质的移位,导致其中一个主要血管几乎完全阻塞到肺部。虽然受感染物质的移位和旅行是有据可查的,主要动脉的相关阻塞是罕见的。
    Infective endocarditis (IE) is a relatively rare but life-threatening condition with potential complications such as valve dysfunction, abscess formation, development of penetrating lesions and embolization of septic material. In this case report, we describe the case of a 56-year-old with IE involving the tricuspid valve and resulting in near total occlusion of the right pulmonary artery due to embolization of a massive piece of septic material. While embolization of septic material is well documented, associated occlusion of the right pulmonary artery is rare.
    Infective endocarditis (IE) is a rare but life-threatening condition with potential complications such as heart valve dysfunction, formation of collections of infected material, development of defects in the heart, and the travel of infected material causing blockages. In this case report, we describe the case of a 56-year-old with IE involving one of the heart valves and resulting in near total blockage of one of the main blood vessels to the lungs due to the dislodgement of a large piece of infected material. While dislodgement and travel of infected material is well documented, associated blockages of the main arteries is rare.
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  • 文章类型: Case Reports
    由厌氧菌引起的上呼吸道感染,包括咽炎和扁桃体炎,是脓毒性血栓形成(Lemierre综合征)的常见原因。虽然中耳炎很少进展为全身性感染,中耳周围的脓肿会影响中枢神经系统。伯纳氏菌最初被认为是一种非致病性需氧细菌,但后来被报道会引起菌血症和脑脓肿。这里,我们报告一例伯纳迪氏杆菌引起的中耳炎并发脑膜炎,硬膜下积脓,和有免疫能力的患者的脓毒性肺栓塞。
    Upper airway infections caused by anaerobic bacteria, including pharyngitis and tonsillitis, are a common cause of septic thrombosis (Lemierre\'s syndrome). Although otitis media rarely progresses to systemic infection, an abscess surrounding the middle ear can affect the central nervous system. Trueperella bernardiae was originally considered a non-pathogenic aerobic bacterium but has subsequently been reported to cause bacteremia and brain abscesses. Here, we report a case of otitis media caused by T. bernardiae complicated by meningitis, subdural empyema, and septic pulmonary emboli in an immunocompetent patient.
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  • 文章类型: Observational Study
    背景:化脓性肺栓塞是一种罕见的儿童疾病。我们的目的是评估临床,微生物,以及儿童脓毒性肺栓塞(SPE)的放射学特征和结局,并确定这种异常疾病患者院内死亡率的任何预测因素,以提高预后和治疗。
    方法:一项回顾性研究,旨在搜索儿科肺科住院儿童的电子病历,坦塔大学医院在2015年1月至2022年6月期间诊断为SPE。
    结果:确定了17名儿科患者;10名男性和7名女性,平均年龄9.4±5.2岁。最常见的主诉是发热和呼吸急促(n=17),其次是胸痛(n=9)。苍白(n=5),肢体肿胀(n=4),背痛(n=1)。耐甲氧西林金黄色葡萄球菌(MRSA)是9例患者中最常见的病原体。最常见的肺外脓毒血症灶是5例患者的脓毒性关节炎(29.4%),4例患者的化脓性血栓性静脉炎(23.5%),和感染性心内膜炎2例(11.8%)。所有患者在CT胸部均表现为楔形周边病变及摄食血管征,而双侧弥漫性病变,结节性病变,94.1%的患者存在空化,58.8%的患者出现胸腔积液,在41.2%的患者中发现气胸。15例患者好转并存活(88.2%),2例患者死亡(11.8%)。
    结论:SPE的早期诊断与早期积极治疗是一个更好的结果的关键,包括适当的抗生素和及时的手术干预以根除肺外脓毒血症灶。
    Septic pulmonary embolism is a rare disease in children. We aimed to assess the clinical, microbiological, and radiological characteristics and outcomes of pediatric septic pulmonary embolism (SPE) and to identify any predictive factors for in-hospital mortality in patients with this unusual disease to enhance prognosis and treatment.
    A retrospective study to search the electronic medical records of children admitted to the pediatric pulmonology unit, Tanta University hospital with the diagnosis of SPE between January 2015 and June 2022.
    Seventeen pediatric patients were identified; ten males and seven females with a mean age of 9.4 ± 5.2 years. The most common presenting complaints were fever and shortness of breath (n = 17) followed by chest pain (n = 9), pallor (n = 5), limb swelling (n = 4), and back pain (n = 1). Methicillin-resistant Staphylococcus aureus (MRSA) was the most common causative pathogen in nine patients. The most common extra-pulmonary septic foci were septic arthritis in five patients (29.4%), septic thrombophlebitis in four patients (23.5%), and infective endocarditis in two patients (11.8%). All patients exhibited wedge-shaped peripheral lesions and feeding vessel sign in CT chest, whereas bilateral diffuse lesions, nodular lesions, and cavitation were present in 94.1% of patients, pleural effusion was identified in 58.8% of patients, and pneumothorax was detected in 41.2% of patients. Fifteen patients improved and survived (88.2%), while two patients died (11.8%).
    Early diagnosis of SPE with vigorous early therapy is critical for a better outcome, including appropriate antibiotics and timely surgical interference to eradicate extra-pulmonary septic foci.
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  • 文章类型: Case Reports
    脓毒症肺栓塞(SPE)是一种罕见的并发症,当感染的血栓从原始感染部位破裂并转移到肺血管时,就会发生。引起梗塞或脓肿。在SPE上报告了病例,三尖瓣或肺动脉瓣心内膜炎是最常见的主要部位,尤其是静脉吸毒者。有,然而,关于化脓性海绵窦血栓形成(CST)引起SPE的报道很少。这里,我们描述了一个18岁的男性,他的左眼睑上有一个脓包,之后他出现了发烧,他的左眼自发肿胀,跟着他的右眼,伴随着双侧眼球突出和复视,和新发的呼吸困难.听诊显示左肺区域的呼吸音减少。磁共振成像(MRI)显示海绵窦血栓形成。血液培养分离金黄色葡萄球菌。高分辨率计算机断层扫描(HRCT)显示左侧气胸,胸腔积液最少,两肺中散布着多个结节,提示感染性肺栓塞.我们报告这个病例是为了传达一个小病变,也就是说,眼睑脓疱(style),会变得复杂,引发一系列意想不到的事件,挑战医生,需要严格的方法。
    Septic pulmonary embolism (SPE) is a rare complication that happens when infected thrombi from the original site of infection break off and travel to the pulmonary blood vessels, causing an infarction or an abscess. Cases were reported on SPE, with tricuspid or pulmonary valve endocarditis being the most common primary site, especially in intravenous drug abusers. There are, however, very few reports of SPE brought on by septic cavernous sinus thrombosis (CST). Here, we describe the case of an 18-year-old male who had a pustule on his left eyelid, after which he developed fever, spontaneous swelling of his left eye, followed by his right eye, along with bilateral proptosis and diplopia, and new-onset dyspnea. Auscultation revealed decreased breath sounds in the left lung fields. Magnetic resonance imaging (MRI) revealed cavernous sinus thrombosis. Blood cultures isolated Staphylococcus aureus species. High-resolution computed tomography (HRCT) revealed a left-sided pneumothorax with minimal pleural effusion and multiple nodules scattered among both lungs, suggesting septic pulmonary emboli. We report this case to convey how a minor lesion, that is, an eyelid pustule (stye), can get complicated and set off a spiral of events that takes an unexpected tangent, challenging physicians and necessitating a rigorous approach.
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