Recurrent SDSE bacteraemia resulting in streptococcal toxic shock syndrome in a patient with Noonan syndrome.
Recurrent SDSE bacteraemia resulting in streptococcal toxic shock syndrome in a patient with Noonan syndrome.
复制标题
努南综合征患者反复出现 SDSE 菌血症，导致链球菌中毒性休克综合征。
DOI：
10.1136/bcr-2016-216092
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Imai H.
中科院分区：
文献类型：
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作者：
Suzuki K;Nakamura A;Ishikura K;Imai H.
一名19岁的男子与慢性淋巴水肿由于努南综合征提出了在我们的医院感染性休克和疼痛，在他的小腿。血培养结果为类半乳链球菌（SDSE）阳性，诊断为中毒性蜂窝织炎。患者接受氨苄青霉素治疗3周。 虽然他做了6周，败血性休克复发。 血培养再次显示SDSE，菌株与第一次发作相同，表明该感染复发。他用氨苄青霉素治疗6周，用甲氧苄啶-磺胺甲恶唑治疗12个月。 虽然SDSE菌血症通常发生在老年患者中，但该患者的研究结果表明，它也可发生在具有易感因素的年轻人中。该病例还表明，尽管通常给予足够的抗生素，SDSE仍有复发的可能，并且经历复发发作的患者可能需要延长抗生素治疗，包括预防。
A 19-year-old man with chronic lymphoedema due to Noonan syndrome presented at our hospital with septic shock and pain in his lower leg. Blood cultures were positive forStreptococcus dysgalactiaesubspequisimilis(SDSE), resulting in a diagnosis of cellulitis with toxic involvement. He was treated with ampicillin for 3 weeks. Although he did well for 6 weeks, septic shock recurred. Blood culture again revealed SDSE, with the strain being identical to the first episode, suggesting that this infection had relapsed. He was treated with ampicillin for 6 weeks and prophylactically with trimethoprim-sulfamethoxazole for 12 months. Although SDSE bacteraemia occurs commonly in elderly patients, findings in this patient showed that it can also develop in younger persons with predisposing factors. This case also indicates that SDSE has the potential to recur, despite generally sufficient antibiotic administration, and that patients who experience recurrent episodes may require prolonged treatment with antibiotics, including prophylaxis.