Klebsiella pneumoniae-related invasive liver abscess syndrome complicated by purulent meningitis: a review of the literature and description of three cases.
Klebsiella pneumoniae-related invasive liver abscess syndrome complicated by purulent meningitis: a review of the literature and description of three cases.
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DOI：
10.1186/s12879-020-05702-3
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发表时间：
2021-01-06
影响因子：
3.7
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Sun R;Zhang H;Xu Y;Zhu H;Yu X;Xu J
肺炎克雷伯菌（肺炎克雷伯菌）侵袭性肝脓肿综合征（ILAS）合并化脓性脑膜炎在中国大陆少见。去年冬天，我们接收了3例肺炎克雷伯菌脑膜炎病例，他们都在短时间内死亡。我们报道这些病例是为了找出高死亡率的原因，并讨论如何有效地改善这些患者的预后。3例糖尿病患者发生脓肿和化脓性脑膜炎。入院时临床表现、血、脑脊液实验室检查及影像学检查均符合肺炎克雷伯菌ILAS合并脑膜炎转移感染。即使及时给予充分的抗生素治疗和严格的血糖控制，所有患者的病情仍迅速恶化并在短时间内死亡。患者预后不良的原因可能是肝脓肿引流不清、脑脊液蛋白水平高提示严重炎症，以及患者居住地张家口肺炎克雷伯菌特有但毒力较强的未知因素。建议严格控制血糖，早期引流肝脓肿，适当应用抗生素治疗，肺炎克雷伯菌脑膜炎的发病机制和治疗的进一步研究可能有助于患者获得更好的预后。
Klebsiella pneumoniae (K. pneumoniae) invasive liver abscess syndrome (ILAS) with purulent meningitis was rarely identified the mainland of China. Last winter, we received 3 cases of K. pneumoniae meningitis and all of them died in a short time. We report these cases in order to find the reason of high mortality and discuss effective effort to improve these patients’ prognosis. Three patients with uncontrolled diabetes developed live abscess and purulent meningitis. Upon admission, the clinical manifestations, laboratory result of blood and cerebrospinal fluid (CSF) and imaging examinations were compatible with K. pneumoniae ILAS which had metastasis infection of meningitis. Even with timely adequate antibiotic therapy and strict glycemic control, all of the patients’ condition deteriorated rapidly and died in a short time. The reason of patients’ poor prognosis might be the absence of liver abscess drainage, high level of CSF protein which indicates severe inflammation and unknown special but stronger virulence factors of K. pneumoniae the patients’ living place Zhangjiakou. Strict glycemic control, early drainage of liver abscess and appropriate antibiotic application are recommended for treating this condition, further progress on the pathogenesis and treatment of K. pneumoniae meningitis may help patients gain a better prognosis.
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影响因子：
12
作者：
Boglione, Lucio;Spezia, Claudia;Caramello, Pietro
通讯作者：
Caramello, Pietro
DOI：
10.1016/s1201-9712(03)90060-9
发表时间：
2003-09-01
期刊：
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
影响因子：
--
作者：
Giobbia, Mario;Scotton, Pier Giorgio;Vaglia, Alberto
通讯作者：
Vaglia, Alberto
影响因子：
3.7
作者：
Tan, Jing-Yu;Suen, Lorna K. P.;Molassiotis, Alexander
通讯作者：
Molassiotis, Alexander
影响因子：
4.9
作者：
Lin, Yi-Tsung;Cheng, Yi-Hsiang;Chen, Liang
通讯作者：
Chen, Liang
DOI：
10.1007/s10096-003-0963-x
发表时间：
2003-08-01
影响因子：
4.5
作者：
Habib, AG;Tambyah, PA
通讯作者：
Tambyah, PA