Case Report: Diagnosis of Klebsiella pneumoniae Invasive Liver Abscess Syndrome With Purulent Meningitis in a Patient From Pathogen to Lesions.
Case Report: Diagnosis of Klebsiella pneumoniae Invasive Liver Abscess Syndrome With Purulent Meningitis in a Patient From Pathogen to Lesions.
复制标题
肺炎克雷伯菌侵袭性肝脓肿综合征合并化脓性脑膜炎从病原到病变的诊断
DOI：
10.3389/fmed.2021.714916
复制
发表时间：
2021
影响因子：
3.9
通讯作者：
Zhang HN
中科院分区：
文献类型：
--
作者：
Zeng S;Yan WQ;Wu XM;Zhang HN
作为决定性的人类病原体，已知肺炎肺炎会引起罕见的肺炎肝脓肿综合征（KLAS），在早期在亚洲更为常见，现在越来越多地在亚洲以外。患有脓毒症转移性眼或中枢神经系统（CNS）病变的KLA患者与高发病率和死亡率有关。相对不频繁的成人社区获得的肺炎脑膜炎已被记录在记录中，大多数人的预后较差。在本文中，我们报道了一例KLA呈现出脓性脑膜炎作为疾病发作的情况。虽然在CSF，血液或肝脓的细菌培养物中获得了阴性结果，但CSF的宏基因组下一代测序（MNG）以及同步进行的血液样本证明了肺炎的Klebsiella肺炎作为致病性微生物（13,470和5,470和5,31318独特的ears，reads，13,470和5,318独特，，，分别）。最终治愈的患者受益于病原体的快速诊断，脓肿的早期经皮引流以及提示适当的抗生素给药。我们的病例强调了使用MNGS早期病原体诊断该疾病的临床医生的重要性。
As a determinant human pathogen, Klebsiella pneumoniae is known to cause rare K. pneumoniae liver abscess syndrome (KLAS) which was more common in Asia in early-stage and reported increasingly outside Asia now. Patients with KLAS who have septic metastatic ocular or central nervous system (CNS) lesions are associated with high morbidity and mortality. Relatively infrequent adult community-acquired K. pneumoniae meningitis have been documented and most were with poor prognosis. In this paper, we reported a case of KLAS presenting purulent meningitis as disease onset. While negative results were obtained in the bacterial culture of CSF, blood, or liver pus, metagenomic next-generation sequencing (mNGS) of CSF, and blood samples which were synchronously performed demonstrated Klebsiella pneumoniae as the pathogenic microorganism (13,470 and 5,318 unique reads, respectively). The ultimately cured patient benefited from rapid pathogen diagnosis, early percutaneous drainage of the abscess, and prompt appropriate antibiotic administration. Our case highlights the importance of clinicians using mNGS for early pathogen diagnosis of this disease.
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DOI：
10.1146/annurev-pathmechdis-012418-012751
发表时间：
2019-01-24
期刊：
Annual review of pathology
影响因子：
--
作者：
Gu W;Miller S;Chiu CY
通讯作者：
Chiu CY
影响因子：
5.7
作者：
Xing, Xiao-Wei;Zhang, Jia-Tang;Yu, Sheng-Yuan
通讯作者：
Yu, Sheng-Yuan
影响因子：
158.5
作者：
Wilson, M. R.;Sample, H. A.;Chiu, C. Y.
通讯作者：
Chiu, C. Y.
影响因子：
11.8
作者：
Miao, Qing;Ma, Yuyan;Hu, Bijie
通讯作者：
Hu, Bijie
影响因子：
3.7
作者：
Sun R;Zhang H;Xu Y;Zhu H;Yu X;Xu J
通讯作者：
Xu J