感染研修mp3來自ipad血液病醫(yī)院1單胞菌

感染病歷分享中國醫(yī)學(xué)科學(xué)院血液病醫(yī)院造血干細(xì)胞移植中心孫佳麗例1患者劉某某，女，53歲，“B-ALL-CR1”。2015.7.31-8.6予EOACP方案鞏固化療2015.8.10-8.19粒缺期，持續(xù)9天，ANC最低0.01×109/L8.13發(fā)熱，T40℃，伴畏寒、寒戰(zhàn)，無腹瀉等不適病例簡介予亞胺培南500mg

q6h初始抗感染治療治療5天，仍發(fā)熱，無其他不適35363738394041體溫℃亞胺培南頭孢哌酮舒巴坦環(huán)丙沙星亞胺培南頭孢哌酮舒巴坦粒缺期血培養(yǎng)維羅納氣單胞菌溫和生物變種肺CT亞胺培南：耐藥改頭孢哌酮舒巴坦3g

q6h+環(huán)丙沙星400mg

bid例2：患者王某某，男，27歲，“AML-M2a-CR1”。2015.10.1-10.7予AA（安吖啶+Ara-c）方案鞏固化療2015.10.12-10.19粒缺期，持續(xù)8天，ANC最低0.05×109/L10.15發(fā)熱，T39.1℃，周身肌肉酸痛，無畏寒、咳嗽、腹瀉等不適病例簡介予亞胺培南1000mg

q8h初始抗感染治療持續(xù)發(fā)熱胸部CT正常CRP

35.3mg/L，內(nèi)毒素0.14

Eu/ml(0-0.08)亞胺培南頭孢哌酮舒巴坦血培養(yǎng)粒缺期替加環(huán)素血培養(yǎng)豚鼠氣單胞菌右腿疼痛腫塊10.21

右側(cè)大腿、小腿肌肉疼痛，可捫及腫塊，有壓痛10.29

疼痛減輕腫塊變大亞胺培南：耐藥10.17改為頭孢哌酮舒巴坦3g

q6h，發(fā)熱逐漸控制11.17

右小腿肌肉腫塊出現(xiàn)液化12.9

腫塊消失AeromonasspeciesAeromonas

species,

Gram-negative,

rod-shaped

bacteria

areubiquitous

in

aquatic

environment,

such

as

fresh

or

brackishwater,

sewage,

soil,

and

tap

water

in

temperate

or

subtropicalcountries.A

recent

study

showed

that

the

average

annual

incidences

ofbacteremia

due

to

Aeromonas

spp.

was

76

cases/millioninhabitants

between

2008

and

2010,

which

was

higher

than

thosein

western

countries.Plos

One

2014,

9

(3):

1-6Infection

ofAeromonasspeciesDespite

the

gastrointestinal

tract

is

the

most

common

site

ofinfections

caused

by

Aeromonas

spp,

extra-intestinalAeromonas

associated

diseases

such

as

empyema,

urinarytract

infections,

biliary

tract

infections,

peritonitis,

and

skinand

soft-tissue

infections

have

also

been

reported.Moreover,

bacteremia

is

another

common

type

of

infectioncaused

by

Aeromonas

species.Plos

One

2014,

9

(3):

1-6Plos

One

2014,

9

(3):

1-6Plos

One2014,9(3):

1-6Plos

One2014,9(3):

1-6Plos

One2014,9(3):

1-6Plos

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