首次发现糖尿病患者食用死鱼后发生弗氏弧菌脑炎1例  

A case report of Vibrio furnissi encephalitis in diabetic patients after eating dead fish

作　　者：骆艳妮[1] 王岗[1] 王小闯[1] 马海畅 侯彦丽[1] 郭蕾[1] LUO Yanni;WANG Gang;WANG Xiaochuang;MA Haichang;HOU Yanli;GUO Lei(Department of Critical Care Medicine,the Second Affiliated Hospital of Xian Jiaotong University,Xian,710004,China)

机构地区：[1]西安交通大学医学院第二附属医院重症医学科,西安710004

出　　处：《临床急诊杂志》2024年第2期83-86,共4页Journal of Clinical Emergency

摘　　要：糖尿病患者感染后并发脓毒症多见,但出现弗氏弧菌脑炎既往没有报道,临床诊断罕见。本病例是血糖控制不佳的糖尿病患者食用烹饪的死鱼后出现恶心、呕吐及腹痛的消化道症状,治疗过程中发现肾结石予以碎石后继发泌尿系脓毒症,随后出现了意识障碍,行脑脊液宏基因二代测序(metagenomic next-generation sequencing,mNGS)考虑弗氏弧菌脑炎,给予多西环素治疗后临床症状好转并出院。弗氏弧菌脑炎罕见,糖尿病患者因不洁饮食,特别是食用不洁的水产品后出现意识障碍,结合患者临床表现、脑脊液mNGS结果可明确诊断,敏感的抗生素是控制病情的关键。Sepsis is a common occurrence in diabetic patients after infection,but Vibrio frei encephalitis has not been reported in the past,and its clinical diagnosis is rare.However,in this case,a diabetic patient with poor blood glucose control developed gastrointestinal symptoms of nausea,vomiting,and abdominal pain after eating cooked dead fish.During the treatment,kidney stones were found and were removed through lithotomy,however urinary tract sepsis was presented,followed by disturbance of consciousness.Cerebrospinal fluid mNGS was considered for Vibrio frei encephalitis.After doxycycline treatment,the patient was discharged.Vibrio frei encephalitis is rare.However,for diabetic patients with an unclean diet,especially after eating contaminated aquatic products,this case was diagnosed by cerebrospinal fluid mNGS and the sensitive antibiotics are the key to control the disease.

关 键 词：糖尿病 弗氏弧菌 脓毒症 宏基因二代测序 

分 类 号：R473[医药卫生—护理学]