野生株肺炎克雷伯杆菌感染致剥脱性皮炎1例

患者男,56岁,全身皮疹伴高热2 d入院,体温持续39℃,躯干和四肢大量疱疹及斑丘疹,右眼结膜充血,有分泌物,舌苔白色假膜;WBC 25.82×10^9/L,CRP 42.11 mg/L,PCT 10.19 ng/mL,CD4值126个/μL,肌酐204μmol/L;CT示:右上中肺薄结节影;腹部MRI示肝结节;口腔白色念珠菌;皮肤病理见真菌孢子;单纯疱疹病毒及肺炎支原体IgM阳性,血和皮肤均培养出野生株肺炎克雷伯菌。诊断:①败血症;②剥脱性皮炎;③口腔及皮肤真菌感染。

A Case of Exfoliative Dermatitis Caused by Klebsiella Pneumoniae Infection in Wild Strains

A 56-year-old male presented systemic rash and high fever with temperature 39 ℃ for two days.Physical examination showed a large number of herpes and papules on the trunk and limbs,right eye conjunctival congestion,secretion,tongue coating white pseudomembrane.Laboratory examination showed WBC was 25.82×10^9/L,CRP was 42.11 mg/L,PCT was 10.19 ng/mL,CD4 value was 126/μL and creatinine was 204 μmol/L.CT image showed nodules on the upper right and middle lung,and the abdomen MRI showed liver nodules.Oral Candida albicans with saw fungal spores,herpes simplex virus and Mycoplasma pneumonia was IgM positive,both blood and skincultivated with wild strains Klebsiella pneumoniae.Sepsis,exfoliative dermatitis and oral and skin fungal infections was diagnosed.