摘要
一例中年男性口腔恶性肿瘤行TP方案化疗两个疗程后,出现粒细胞严重缺乏。患者因确诊右侧口咽恶性肿瘤1+个月、腹痛1 d于急诊科就诊,体查右下牙龈磨牙后可见一红色糜烂面,局部可见一病变,表面粗糙,边界欠清。1 d前患者口服秋水仙碱后出现上腹疼痛,呈烧灼样痛,伴腹泻。患者既往无特殊病史,有吸烟饮酒史。患者恶性肿瘤伴严重粒缺处于免疫缺陷状态,需警惕严重血流感染并发症,入院当日立即予以抽血培养两套送检,并经验性给予头孢他啶抗感染治疗,但患者次日经两次积极抢救后无效最终死亡。入院2 d后血培养报阳,最终证实是由生痰二氧化碳嗜纤维菌引起的血流感染。结合文献复习及分析,笔者发现生痰二氧化碳嗜纤维菌引起患者血流感染临床少见,这类患者的处置关键在于早期辨别这种病原微生物,积极寻找感染源,早诊断,早治疗,是提高患者生存率的关键所在。
After 2 cycles of TP regimen chemotherapy,a middle-aged male patient with oral malignant tumor developed severe granulocytopenia.The patient,diagnosed with malignant tumor on the right oropharynx a month ago,presented to the Emergency Department with 1 day of abdominal pain.Upon physical examination,a red ulcerated area was observed on the lower right gum after grinding teeth,with a local lesion characterized by a rough surface and unclear borders.One day before,the patient experienced epigastric pain,burning sensation,and diarrhea after taking colchicine orally.The patient had no significant medical history but had a history of smoking and alcohol consumption.With the malignant tumor and severe granulocyte deficiency,the patient was in an immunocompromised state,necessitating vigilance for severe bloodstream infections and complications.Immediately upon admission,two sets of blood cultures were obtained for testing,and empirical cefotaxime was administered for antimicrobial therapy.Despite two unsuccessful resuscitation attempts the following day,the patient eventually passed away.Blood cultures taken on the second day of hospitalization became positive,confirming a bloodstream infection caused by Capnocytophaga sputigena.Reviewing the literature,it was noted that bloodstream infections caused by Capnocytophaga sputigena are clinically rare.Early identification of this pathogenic microorganism,prompt identification of the infection source,early diagnosis,and timely treatment are crucial for improving patient survival rates in such cases.
作者
安政远
谭茂刚
母文浪
鲁旭
何琴
余孟飞
李明哲
陈泽慧
AN Zheng-yuan;TAN Mao-gang;MU Wen-lang;LU Xu;HE Qing;YU Meng-fei;LI Ming-zhe;CHEN Ze-hui(Department of Medical Laboratory,People's Hospital of Dejiang,Dejiang 565200,Guizhou,CHINA;Department of Medical Laboratory,the Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,CHINA)
出处
《海南医学》
CAS
2024年第14期2089-2093,共5页
Hainan Medical Journal
基金
贵州省科学技术厅科学技术基金项目(编号:黔科合支撑[2021]一般034)。
关键词
生痰二氧化碳嗜纤维菌
血流感染
口腔恶性肿瘤
Capnocytophaga sputigena
Bloodstream infection
Malignant neoplasm of oral cavity
