Clostridium perfringens sepsis in three patients with acute leukemia and review of the literature.
Clostridium perfringens sepsis in three patients with acute leukemia and review of the literature.
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DOI：
10.1007/s12185-020-03060-z
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发表时间：
2021-04
影响因子：
2.1
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Liu F;Xue S;Zhang Y;Yang J;Hu J;Li D;Ma X;Wang J
在本研究中，我们旨在提高对急性白血病患者产气荚膜梭菌脓毒症的临床表现、实验室检查结果及危险因素的认识，并分析改善预后的治疗策略。我们分析了3例急性白血病患者的产气荚膜梭菌脓毒症的临床表现、实验室资料、诊断和治疗策略。我们还回顾和分析了相关文献，将我们的发现纳入讨论。3例患者化疗后均出现感染性休克伴中性粒细胞减少。血液样本分析证实产气荚膜原菌存在，2例患者出现暴发性血管内溶血，并发多器官功能障碍综合征。尽管及时和全剂量的抗菌治疗、血液净化和无创正压通气，2例患者存活，1例死亡。总的来说，我们的研究结果表明产气荚膜梭菌脓毒症在急性白血病患者中很少见，但进展迅速。观察到高死亡率，患者常发生难治性休克和血管内溶血。这表明早期发现和诊断的重要性。多模式治疗，包括液体复苏、抗生素、器官支持和血液净化，对成功至关重要。
In this study, we aimed to improve understanding of the clinical manifestations, laboratory findings, and risk factors of Clostridium perfringens sepsis in patients with acute leukemia and to analyze treatment strategies for improving prognosis. We analyzed clinical manifestations, laboratory data, diagnosis, and treatment strategies in three cases of C. perfringens sepsis in patients with acute leukemia. We also reviewed and analyzed the relevant literature, incorporating our findings into the discussion. All three patients developed septic shock with neutropenia following chemotherapy. Analysis of blood samples confirmed the presence of C. perfringens, and two patients had fulminant intravascular hemolysis and developed multiple organ dysfunction syndrome. Two patients survived and one died despite timely and full-dose antibacterial treatments, blood purification, and noninvasive positive pressure ventilation. Overall, our findings showed that C. perfringens sepsis is rare in patients with acute leukemia but progresses rapidly. A high mortality rate was observed, and patients often experienced refractory shock and intravascular hemolysis. This demonstrates the importance of early detection and diagnosis. Multimodal treatments, including fluid resuscitation, antibiotics, organ support, and blood purification, are essential for success.
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影响因子：
13.2
作者：
Kiu R;Hall LJ
通讯作者：
Hall LJ
影响因子：
38.9
作者：
Payen, Didier M.;Guilhot, Joelle;Launey, Yoann;Lukaszewicz, Anne Claire;Kaaki, Mahmoud;Veber, Benoit;Pottecher, Julien;Joannes-Boyau, Olivier;Martin-Lefevre, Laurent;Jabaudon, Matthieu;Mimoz, Olivier;Coudroy, Remi;Ferrandiere, Martine;Kipnis, Eric;Vela, Carlos;Chevallier, Stephanie;Mallat, Jihad;Robert, Rene
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9.6
作者：
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通讯作者：
Siegel, Mark D.
影响因子：
1.1
作者：
Medrano-Juarez, R. M.;Sotello, D.;Nugent, K.
通讯作者：
Nugent, K.
影响因子：
2.6
作者：
Vaiopoulos, G;Calpadaki, C;Pangalis, GA
通讯作者：
Pangalis, GA