| 刘斌,黄彭,梁彦超,等.侵袭性肺炎克雷伯菌肝脓肿综合征 1例并文献复习[J].安徽医药,2024,28(11):2282-2285. |
| 侵袭性肺炎克雷伯菌肝脓肿综合征 1例并文献复习 |
| Invasive Klebsiella pneumoniae liver abscess syndrome: one case report and literature review |
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| DOI：10.3969/j.issn.1009-6469.2024.11.036 |
| 中文关键词: 肝脓肿 肺炎克雷伯菌 侵袭综合征 |
| 英文关键词: Liver abscess Klebsiella pneumoniae Invasive syndrome |
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| 中文摘要: |
| 目的探讨侵袭性肺炎克雷伯菌肝脓肿综合征的临床特点。方法分析1例确诊为侵袭性肺炎克雷伯菌肝脓肿综合征病人的病历资料，并进行相关文献检索及复习。结果共检索到国内外文献 48篇，除临床资料不完整和非英文文献外，获取病例报道文献 26篇，加该研究病例共纳入 38例病人。合并糖尿病病人 23例( 60.5%)，肝脓肿位于右肝 23例，单发脓肿 20例，多发脓肿 16例；病原学主要来源于血液和肝脓液培养，分别为 26例和 16例；侵袭部位主要为肺和血流，分别为 26例和 28例； 38例病人培养鉴定的肺炎克雷伯菌多为敏感菌株，仅 2例出现多耐药和泛耐药，总体耐药率相对较低。所有病人经抗感染治疗，其中 19例行肝脓肿穿刺引流。 32例病人经敏感抗生素治疗好转， 6例死亡，其中 5例出现颅内感染。结论侵袭性肺炎克雷伯菌肝脓肿综合征是一种严重的多部位感染的疾病，多见于糖尿病病人，容易导致败血症，合并颅内感染者病死率高。早期、充分、全程抗菌治疗或肝脓肿穿刺引流，可改善临床预后。 |
| 英文摘要: |
| Objective To investigate the clinical features of invasive Klebsiella pneumoniae liver abscess syndrome (IKLAS).Meth? ods Medical record of a patient with IKLAS was analyzed, and the relevant literature was searched and reviewed.Results A total of 48 domestic and foreign literatures were retrieved. Except for incomplete clinical data and non-English literature, 26 case reports wereobtained. There were 23 patients (60.5%) with diabetes mellitus, 23 patients with liver abscess located in the right liver, 20 patientswith single abscess, and 16 patients with multiple abscesses. The etiology was mainly established by blood and liver pus culture (26 patients and 16 patients, respectively). The main sites of invasion were lung and blood flow (26 patients and 28 patients, respectively).Most of the Klebsiella pneumoniae cultured in 38 patients were sensitive strains, and only 2 patients developed multi-drug resistance and pan-resistance. The overall drug resistance rate was relatively low. All patients received anti-infection treatment, and 19 of them underwent liver abscess puncture and drainage. Tirty-two patients improved after sensitive antibiotic treatment, 6 died, and 5 developed an intracranial infection.Conclusion IKLAS is a severe disease with multiple-site infection, which is more common in patientswith diabetes mellitus and easily leads to sepsis, with a high mortality rate associated with intracranial infection. Early, sufficient andwhole-course antibacterial treatment or puncture and drainage of liver abscess can improve the clinical prognosis. |
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