血液系统疾病患者嗜水气单胞菌感染5例并文献复习  

Aeromonas hydrophila infection in patients with hematologic disease:a report of 5 cases and literature review

作　　者：胥艳玲 毕慧[2] 杨旭[1] 夏晴 吕梅 和平安 XU Yanling;BI Hui;YANG Xu;XIA Qing;Lü Mei;HE Pingan(Department of Laboratory Medicine,the Second Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第二附属医院检验科,昆明650032 [2]昆明医科大学第二附属医院血液科,昆明650032

出　　处：《中国感染与化疗杂志》2022年第6期713-720,共8页Chinese Journal of Infection and Chemotherapy

基　　金：国家科技基础资源调查专项(2019FY101200,2019FY101209)。

摘　　要：目的描述和分析血液系统疾病患者合并嗜水气单胞菌感染的临床特点及转归。方法报道1例血液系统疾病合并嗜水气单胞菌感染的患者,同时回顾昆明医科大学第二附属医院近五年发生的4例感染病例,并通过PubMed、迈特思创、中国知网、万方数据库检索国内外中英文文献,筛选资料相对完整的病例进行系统性回顾。结果该患者系急性淋巴细胞白血病合并嗜水气单胞菌感染,发展为坏死性筋膜炎,经治疗无效死亡。检索到资料相对完整的文献病例有14例。患者临床表现多不典型,症状多样,高热是最常见的临床症状,同时还伴有胃肠道症状等。若只表现为发热,无明显的感染灶往往预后较好,伴皮肤软组织感染者死亡率较高。经χ^(2)检验分析,持续处于粒细胞缺乏期有更高的嗜水气单胞菌感染率(P=0.02)。结论血液系统疾病患者合并嗜水气单胞菌感染罕见但致死率高,应引起临床重视。Objective To investigate the clinical features and outcome of Aeromonas hydrophila infection in patients with hematologic disease.Methods A case of necrotizing fasciitis caused by A.hydrophila was reported in a patient with hematologic disease.Additional 4 cases of such infections treated in the Second Affiliated Hospital of Kunming Medical University during the past 5 years were also reviewd retrospectively.PubMed,Foreign Medical Literature Retrieval Service(FMRS),China National Knowledge Infrastructure(CNKI)and Wanfangdata databases were searched for relevant reports of A.hydrophila infection during the same period.Data were extracted and analyzed using Chi-square tests.Results The patient had acute lymphoblastic leukemia complicated with necrotizing fasciitis due to A.hydrophila infection,and finally died after ineffective treatment.A total of 19 patients were identified with A.hydrophila infection for this analysis.The clinical manifestations were atypical and the symptoms are diverse.High fever was the most common clinical symptom,associated with gastrointestinal symptoms.Fever alone without apparent site of infection usually predicted good prognosis.The mortality was higher in the patients with skin and soft tissue infection.Chi-square test suggested that chronic neutropenia was associated with higher rate of A.hydrophila infection(P=0.02).Conclusions A.hydrophila infection is an uncommon but highly fatal condition that requires special attention in clinical settings.

关 键 词：嗜水气单胞菌 血液系统疾病 白血病 粒细胞缺乏 

分 类 号：R515[医药卫生—内科学]