| 唐鸿,方小谦.伴放线凝聚杆菌菌血症致双小腿迁徙性细菌性肌炎1例并文献复习[J].安徽医药,待发表. |
| 伴放线凝聚杆菌菌血症致双小腿迁徙性细菌性肌炎1例并文献复习 |
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| 投稿时间：2025-09-26 录用日期：2025-11-06 |
| DOI： |
| 中文关键词: 伴放线凝聚杆菌 菌血症 心内膜炎 细菌性肌炎 迁徙性感染 多学科协作 多模态影像学 |
| 英文关键词: |
| 基金项目:江苏省中医经典名方评价与转化工程研究中心课题项目(GCZX-20240104) |
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| 中文摘要: |
| 目的? 探讨伴放线凝聚杆菌(Aggregatibacter actinomycetemcomitans,Aa)菌血症致双小腿迁徙性细菌性肌炎的临床特点、诊断思路及治疗策略。方法? 回顾性分析南京市中西医结合医院于2024年5月29日收治的1例Aa菌血症致双小腿迁徙性细菌性肌炎的临床资料并复习相关文献。结果? 男,31岁,无牙周病基础,表现为寒战高热及双小腿游走性剧痛,在多学科协作诊疗(MDT)模式下,经血培养和心脏彩超、肌肉MRI、红外热成像等多模态影像学检查确诊,给予先后静滴氨苄西林8d、哌拉西林他唑巴坦13d及序贯口服阿莫西林克拉维酸钾14d的5周抗炎治疗,好转出院。结论 Aa感染以牙源性感染和感染性心内膜炎(Infective Endocarditis,IE)常见,并发远处软组织及肌肉的迁徙性感染灶罕见。该菌所致菌血症,即使无典型口腔疾病,也应积极探寻其他潜在感染源；运用针对性的多模态影像学技术对于排查IE和早期发现并定位罕见迁徙灶具有重要价值。尽早启动MDT,遵循指南足量、足疗程的抗生素治疗,是成功管理此类复杂感染的关键。 |
| 英文摘要: |
| Objective? To explore the clinical characteristics, diagnostic approach, and treatment strategies of migratory bacterial myositis of both lower legs caused by Aggregatibacter actinomycetemcomitans (Aa) bacteremia. Methods? The clinical data of a patient admitted to Nanjing Hospital of Integrated Traditional Chinese and Western Medicine on May 29, 2024, with Aa bacteremia-induced migratory bacterial myositis of both lower legs were retrospectively analyzed, and relevant literature was reviewed. Results? Male, 31 years old, without periodontal disease background, presented with chills, high fever, and migratory severe pain in both lower legs. Under the multi-disciplinary collaborative diagnosis and treatment (MDT) model, the diagnosis was confirmed through blood culture and multimodal imaging examinations such as echocardiography, muscle MRI, and infrared thermography. The patient received 5 weeks of anti-inflammatory treatment consisting of intravenous ampicillin for 8 days, piperacillin-tazobactam for 13 days, and sequential oral amoxicillin-clavulanate for 14 days. The patient recovered and was discharged. Conclusion? Aa infection is commonly caused by odontogenic infection and infective endocarditis (Infective Endocarditis, IE). Rarely, there are migratory infection foci in distant soft tissues and muscles. For Aa bacteremia, even without typical oral diseases, other potential infection sources should be actively sought; the use of targeted multimodal imaging techniques is of great value for screening IE and early detection and localization of rare migratory foci. Early initiation of MDT and following the guidelines for adequate and full-course antibiotic treatment is the key to successfully managing such complex infections. |
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