念珠菌败血症12例

近年来 ,真菌性败血症的发病率明显增加 ,临床以念珠菌性感染最为常见 ,其早期诊断困难 ,病死率高达 4 1% [1] 。现将我院 1998年 7月至 2 0 0 1年 12月经血培养证实的 12例念珠菌败血症作一分析 ,报告如下。1　临床资料1.1　一般资料　 12例中男 8例 ,女 4例 ,年龄 14～ 90岁 ,中数年龄 6 5岁。基础疾病 :胃癌伴腹腔广泛转移、坏死性胰腺炎、慢性阻塞性肺疾病并慢性呼吸衰竭急性发作各 2例 ,白血病、肝炎后肝硬化、冠心病并重度心衰、脑出血、帕金森病合并脑大面积梗死、颅脑外伤昏迷各 1例。1.2　主要合并症　合并多脏器功能衰竭 4例 ,细…     

颅骨慢性骨髓炎1例

患者，男，24岁，因突发头痛半月余，用手触及后枕部呈乒乓样感而入院，查体：体温36.8℃，脉博75次/min，呼吸14次/min，血压120/80mmHg，后枕正中可触及骨质薄弱区。CT后枕骨局限性骨质破坏，内外板变薄。MRI示枕部中线区颅骨内见椭圆形囊性病灶，呈长T1，长T2信号，     

中西医治疗慢性骨髓炎25例体会

临床中常见由于急性骨髓炎治疗不及时或不当,往往演变为慢性骨髓炎[1]。常见局部红肿、疼痛、流脓、反复发作,病人十分痛苦。我院2005~2006年采用中西医结合的方法,治疗慢性骨髓炎患者25例,效果良好,现报告如下。1资料与方法1.1临床资料本组慢性骨髓炎患者25例,男性17例,女性8例,年龄25~54岁,平均34岁。西医治疗11例,中西医结合治疗14例。患者病程8~19个月,以往均有开放性骨折病史,原骨折局部急性炎症反复发作,破溃流脓及小块死骨排出史。临床症状表现为局部肿胀,骨质增厚,表面粗糙,压痛,一处或多处窦道,伤口长期不愈或暂时愈合后出现全身发…     

胫骨慢性骨髓炎合并Brodie''''s脓肿1例

者女,45岁.左小腿疼痛1年,加重1月余.X线平片:左胫骨中下段髓腔模糊、密度增高,下段干骺端髓腔内示约1.0 cm×2.0 cm囊状透光区,呈"分叶状",边缘硬化,硬化带与正常骨质间无明显边界,骨膜反应不明显.CT检查:左胫骨中下段骨皮质略增厚,髓腔内密度增高,于左胫骨下段髓腔内示约1.3 cm×1.0 cm×2.7 cm梭形囊状透光区,囊壁硬化,囊腔密度均匀,CT值50 Hu,局部软组织稍肿胀(图1).     

多杀巴斯德菌致骨髓炎1例

<正>巴斯德菌是一种需氧或兼性厌氧的革兰阴性小杆菌,常寄生于猫、狗、家禽等动物体内,是一种动物致病菌,极少引起人类感染,致人感染的病例多由猫、狗的抓咬或舔舐而起病^[1]。巴斯德菌属包括12个种3个亚种,其中多杀巴斯德、犬巴斯德、达可巴斯德、产气巴斯德、咬伤巴斯德感染报道较多,可致血流感染、肺部感染、伤口感染、脑膜炎、关节炎、骨髓炎等^[2-3]。     

超声诊断慢性化脓性骨髓炎1例

患者男性 ,2 1岁。无诱因右大腿中下段肿痛 2年 ,近 2个月加剧。查体 :右大腿中下段肿胀 ,内测深压痛 ,皮肤未见发红 ,皮温稍高。超声检查 :右大腿中下段内侧软组织内探及一个大小约 2 0 cm× 8cm× 5 cm的混合性包块 ,其边界清楚 ,内部回声高低不均 ,中央部见形态不规则的无回声液区 ,大小约 8cm× 2 cm× 2 .5 cm,包块后壁与股骨紧贴 ,骨皮质粗糙不光滑 ,可见约2 .6 cm的连续中断 ,中断的骨片向髓腔隆起 ,表面增厚粗糙 ,回声粗强、杂乱。B超诊断 :右大腿中下段混合性包块伴骨质破坏 ;考虑为股骨中下段慢性化脓性骨髓炎 ,软组织脓肿形成 (…     

中西医结合治疗右下肢全段胫骨化脓性骨髓炎1例

1病例报告患儿,男,9岁,因外伤性右下肢膝关节以下疼痛5天,加剧伴全段红肿2天,高热昏迷10小时,于1998年5月12日8:50AM急诊入院。急查血常规:RBC 5.15×1012/L,Hb 140g/L,WBC 26.3×109/L,N 0.95,L 0.05;尿常规:Pro(+);肾功能正常。右胫骨X线片示:右胫骨全段化脓性骨髓炎。(1)西医治疗:立即建立静脉通道,常规补充水、液、电解质,抗生素选用先锋霉素Ⅴ1.5g静滴,b id,新青霉素Ⅱ3.0静滴,qd在持续硬膜外麻醉下,行右胫骨正中全段切口,剥离骨膜。见骨膜水肿,骨膜下大量积脓。沿右胫骨上中下共开4个窗口,双氧水、0.9%NS+庆大霉素、甲硝唑充…     

心血管系统念珠菌病的抗真菌治疗

心血管系统的念珠菌病主要为念珠菌心内膜炎,其他尚有念珠菌心包炎、心肌炎、化脓性血栓性静脉炎等.念珠菌心内膜炎发生率低,占感染性心内膜炎的1.2%(33/2 749)[1],念珠菌心包炎等其他感染少见.念珠菌心内膜炎的病死率高,其发生率近年来有上升趋势.治疗措施包括抗真菌治疗以及瓣膜置换或其他外科干预.     

念珠菌血症的诊断和抗真菌治疗

近20年来侵袭性真菌感染呈明显增多趋势,研究显示自1979年至2000年真菌所致的脓毒症增加了207%。念珠菌血症为住院患者最常见的侵袭性真菌病。念珠菌血流感染的发病率在不同国家和不同医学中心存在差异。发病率按人口统计为1.5/     

Bilateral Candida endophthalmitis accompanying Candida lusitaniae bloodstream infection: A case report

Candida lusitaniae is an uncommon cause of candidiasis in humans. Ocular manifestations of C. lusitaniae infection have not been reported. C. lusitaniae is either intrinsically resistant to amphotericin B or can acquire such resistance. We describe a case of bilateral endophthalmitis due to C. lusitaniae bloodstream infection in a liver transplant patient with rectal cancer. The patient suffered fungemia and endophthalmitis and was treated with liposomal amphotericin B. The isolate was identified as C. lusitaniae by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, the system based on biochemical tests, and sequencing of the internal transcribed spacer region. The minimal inhibitory concentrations were 0.06 μg/mL for amphotericin B and 2.0 μg/mL for fluconazole. Repeat blood cultures were negative and the endophthalmitis improved following treatment with liposomal amphotericin B. However, the treatment was changed to fluconazole due to nephrotoxicity. No recurrence occurred after completion of treatment.     

Candida lusitaniae septic arthritis: case report and review of the literature

Candida lusitaniae is an infrequently encountered Candida species that has been associated with resistance to amphotericin B. We present a case of septic arthritis with C. lusitaniae and provide a brief review of the organism, especially in regard to current information about its pattern of resistance to antifungal agents.     

Community-acquired osteomyelitis caused by Chryseobacterium meningosepticum: case report and literature review

Chronic sclerosing osteomyelitis caused by Chryseobacterium meningosepticum was observed in a woman with steroid use. Her chronic sclerosing osteomyelitis was cured with ciprofloxacin. English literature review found 4 cases of bone-joint infection due to C. meningosepticum. The implications of treatment with a fluoroquinolone were discussed.     

Infective endocarditis and osteomyelitis caused by Cellulomonas: a case report and review of the literature

Cellulomonas spp. are often believed to be of low virulence and have never been reported as a pathogen causing human disease before. We report the first case of endocarditis caused by Cellulomonas and complicated with osteomyelitis of the lumbar spine in a 78-year-old woman. General weakness and aggravated lower back pain followed by sudden-onset of fever and chills were the major presentation. The diagnosis of infective endocarditis in this case was definitely using the Duke criteria. The magnetic resonance imaging of the lumbar spine revealed infective spondylodisciitis at an early stage. After a full course of antibiotics treatment, the patient's fever subsided but her lower back pain persisted. A slow clinical response to appropriate antimicrobial agents was characteristic of Gram-positive bacillary endocarditis.     

大芬戈尔德菌致肱骨骨髓炎1例报道并文献复习

目的 了解大芬戈尔德菌的特点及其引起疾病的临床特征,提高对该菌引起感染性疾病的认识.方法 回顾性分析1例诊断为大芬戈尔德菌骨髓炎患者的临床资料,结合文献复习探讨大芬戈尔德菌感染性疾病的特征.结果 该例患者临床表现和实验室检查符合大芬戈尔德菌感染性骨髓炎的特征,脓液和组织培养有大芬戈尔德菌生长,术后无复发.复习、汇总文献...     

Chronic carpal tunnel syndrome caused by covert tophaceous gout: A case report

Carpal tunnel syndrome (CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons, tendon sheaths, the carpal tunnel floor, transverse carpal ligament, and even the median nerve, causing various symptoms such as pain, numbness, and weakness. Tophi forming in the carpal canal can compress the median nerve, leading to CTS. Here, we describe a 25-year-old male with a family history of tophaceous gout who presented with typical CTS symptoms. Although he had chronic numbness in his right hand, he failed to present with any obvious palpable masses on his forearm or hand. However, his family history, laboratory, clinical, and magnetic resonance imaging findings were consistent with tophi deposits. CTS symptoms were eased through surgical removal of tophi and decompression of the median nerve. No recurrences of gout and CTS symptoms were reported at a one-year follow-up. This case shows that CTS symptoms could be the initial manifestation of tophaceous gout. In patients with a family history of gout and with CTS symptoms, imaging examinations are critical for early diagnosis and selecting appropriate treatment. Surgical removal of “covert” tophi and decompression of the median nerve is an effective option for eliminating symptoms.