Streptococcus viridans-associated peritonitis after gastroscopy.
Streptococcus viridans-associated peritonitis after gastroscopy.
复制标题
胃镜检查后草绿色链球菌相关性腹膜炎。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
R. Rabagliati
中科院分区：
文献类型：
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作者：
Eduardo Machuca;A. M. Ortiz;R. Rabagliati
内窥镜手术过程中和术后的一过性菌血症是一种有充分证据的现象。绿色链球菌腹膜炎经常与腹膜透析有关，感染可能是由于血液传播、牙科手术或口腔细菌的腔内污染。据我们所知，目前还没有腹膜透析患者胃镜检查后发生腹膜炎的报道。在此，我们报告一例69岁男性患者，接受自动化腹膜透析，需要紧急胃镜检查和硬化治疗加热探头凝固以控制第二天十二指肠溃疡的活动性出血，患者第二天出现恶心和腹痛。腹膜炎的诊断是基于腹水浑浊，白细胞计数为11,500个/微升，中性粒细胞占98%。在腹腔液培养中鉴定出绿色葡萄球菌。患者先用头孢他啶治疗14天，再用克拉霉素治疗7天，顺利康复。接受腹膜透析的患者如果接受食管胃十二指肠镜检查，有发生腹膜炎的风险，因此抗生素预防是可取的。
Transient bacteremia during and after endoscopic procedures is a well-documented phenomenon. Streptococcus viridans peritonitis is frequently associated with peritoneal dialysis, and the infection is probably attributable to hematogenous spread, dental procedures, or transluminal contamination with oral flora. To our knowledge, no reports exist of peritonitis occurring after gastroscopy in peritoneal dialysis patients. Here, we report the case of a 69-year-old male patient receiving automated peritoneal dialysis who required emergency gastroscopy and sclerotherapy plus heat-probe coagulation to control active bleeding from a duodenal ulcer The next day, this patient developed nausea and abdominal pain. The diagnosis of peritonitis was made based on a cloudy peritoneal effluent and a leukocyte count of 11,500 cells/microL with 98% neutrophils. S. viridans was identified in the peritoneal fluid culture. The patient received ceftazidime for 14 days, followed by clarithromycin for 7 days, and he recovered successfully. Patients receiving peritoneal dialysis who undergo esophagogastroduodenal endoscopy are at risk to develop peritonitis, and so antibiotic prophylaxis is desirable.