Staphylococcus aureus bacteremia as a cause of early relapse of thrombotic thrombocytopenic purpura

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a multisystem disease characterized by the sudden onset of hemolytic anemia, thrombocytopenia, fever, renal failure, and neurologic dysfunction, occurring in various combinations. The most effective treatment of TTP is plasma exchange and the administration of corticosteroids, which reduces mortality from the 90 percent seen in untreated patients to 10 percent. CASE REPORTS: Two patients responded favorably to plasma exchange and corticosteroid therapy, but their TTP relapsed during treatment. In both cases, the early relapse of TTP was associated with Staphylococcus aureus bacteremia secondary to central line infection. Treatment of the infection and intensification of the plasma exchange regimen resulted in a sustained remission. CONCLUSION: Infection should be actively sought and treated in TTP patients who are refractory to treatment or in whom an exacerbation of the disease occurs while they are undergoing plasma exchange.     

尿液中阴道加德纳菌的分离培养及药敏试验

目的了解阴道加德纳菌在泌尿系感染中的临床意义及药敏情况。方法收集2011年～2013年6月间由中段尿分离培养的阴道加德纳菌（GV）,对患者的资料和细菌的药敏情况进行分析。结果两年半内分离到的阴道加德纳菌65例,其中男性11例,女性54例,患者尿常规白细胞平均为81．17／HP。药敏对氨苄西林及头孢类敏感。结论阴道加德纳菌除了引起细菌性阴道炎外还可引起泌尿系感染,可通过性途径在男女间传播,应引起重视。甲硝唑和青霉素类药物可用于治疗GV泌尿系感染。