| 老年患者由产气荚膜梭菌引起肺部和血流感染的临床和实验室分析及相关文献复习 |
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| 引用本文： | 吕梅,杨旭,和平安,李庆荣,陶慧婷,张仕茜.老年患者由产气荚膜梭菌引起肺部和血流感染的临床和实验室分析及相关文献复习[J].现代检验医学杂志,2020,0(5):154-158. |
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| 作者姓名： | 吕梅 杨旭 和平安 李庆荣 陶慧婷 张仕茜 |
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| 作者单位： | 昆明医科大学第二附属医院检验科，昆明 650032 |
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| 摘 要： | 目的 分析产气荚膜梭菌引起肺部和血流感染的临床和实验室特点，为临床诊治提供依据。方法 报道一例产
气荚膜梭菌引起肺部感染和血流感染的病例，检索产气荚膜梭菌引起的肺部感染、血流感染文献，结合报道回顾性分析
其临床和实验室特点。结果 报道者系并发慢性疾病的老年男性，胸腔积液和血液分离出产气荚膜梭菌，经抗感染和引
流治疗后，临床症状好转。检索到详尽记录的肺部感染或胸腔积液和血流感染文献各29 例和33 例。29 例肺部感染患者中，
男性21 例和女性8 例，26 例患者伴慢性疾病。临床表现相似，前四位的症状和体征为呼吸困难（22 例）、胸痛（15 例）、
发热（15 例）和咳嗽（12 例）。胸腔积液早期一般呈浑浊、黄绿色或者稀薄血性，晚期为脓性、棕褐色伴恶臭。33 例
血流感染患者中，男性22 例和女性11 例，26 例伴慢性疾病，临床表现复杂。除并发白血病患者外，白细胞和中性粒
细胞计数不同程度升高，血红蛋白不同程度下降，乳酸脱氢酶显著升高。结论 产气荚膜梭菌引起肺部感染和血流感染
多发于并发慢性疾病的老年男性，肺部感染或胸腔积液临床表现相似。血流感染临床表现复杂, 分离出产气荚膜梭菌是
确诊的依据之一，临床应结合患者基本情况综合诊治。
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| 关 键 词： | 产气荚膜梭菌 肺部感染 胸腔积液 血流感染 |
Clinical and Laboratory Analysis and Literature Review of Pulmonary and
Bloodstream Infections Caused by Clostridium Perfringens in Elderly Patients |
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| L? Mei,YANG Xu,HE Ping-an,LI Qing-rong,TAO Hui-ting,ZHANG Shi-xi.Clinical and Laboratory Analysis and Literature Review of Pulmonary and
Bloodstream Infections Caused by Clostridium Perfringens in Elderly Patients[J].Journal of Modern Laboratory Medicine,2020,0(5):154-158. |
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| Authors: | L? Mei YANG Xu HE Ping-an LI Qing-rong TAO Hui-ting ZHANG Shi-xi |
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| Affiliation: | Department of Clinical Laboratory, the Second Affiliated Hospital of Kunming Medical University,Kunming 650032,China |
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| Abstract: | Objective To analyze the clinical and laboratory characteristics of pulmonary and bloodstream infections caused
by Clostridium perfringens（Cp）, so as to provide basis for clinical diagnosis and treatment. Methods A case of pulmonary
infection and blood flow infection caused by Cp was reported. The literature on pulmonary infection and blood flow infection
caused by Cp was searched. Results This report was from an elderly man with chronic disease, who isolated Cp from pleural
effusion and blood,after anti-infection and drainage treatment, the clinical symptoms improved.Detailed records of lung infection
or pleural effusion and bloodstream infection were retrieved in 29 and 33 cases respectively.Of the 29 patients with pulmonary
infection, 21 were males, 8 were females, and 26 were associated with chronic disease.The clinical (15 manifestations were
similar, with symptoms and signs of dyspnea (22 cases), chest pain (15 cases), fever cases), and cough (12 cases).Pleural effusion
was generally cloudy, yellow-green or thin blood in the early stage, and purulent, tan with stench in the late stage.Among the 33
patients with bloodstream infection, there were 22 males, 11 females and 26 patients with chronic diseases, presenting complex
clinical manifestations.In addition to the patients with leukemia, the count of white blood cells and neutrophils increased
to different degrees, the hemoglobin decreased to different degrees, and the lactate dehydrogenase increased significantly.
Conclusion Pulmonary infection and bloodstream infection caused by Cp mostly occured in elderly men with chronic diseases.
The clinical manifestations of pulmonary infection or pleural effusion were similar. The clinical manifestations of bloodstream
infection were complex. The isolation of Cp is one of the basis of diagnosis,and the clinical diagnosis and treatment should be
combined with the basic situation of patients. |
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