侵袭性肺炎克雷伯菌肝脓肿综合征患者临床特征分析

摘要

Objective To analyze the clinical features of invasive Klebsiella pneumoniae liver abscess syndrome (IKLAS). Methods The clinical data of IKLAS patients diagnosed in China-Japan Friendship hospital from January 2010 to October 2017 was analyzed retrospectively. Results There were 9 patients with IKLAS including 6 males and 3 females aged (56. 77 ± 10. 28)years old. Four cases with diabetes mellitus,one case with impaired glucose tolerance,and two cases with cholelithiasis history. Single abscess (7 / 9),multiple abscess(2 / 9). Involved organs:lung(7 / 9),eyes(3 / 9),soft tissue (1 / 9),joint(1 / 9)and nerve system(1 / 9). Laboratory test showed an elevation of the white blood cell count (8 / 9),the al-anine aminotransferase (9 / 9)and the PCT (7 / 9 ),and only one ESBL positive Klebsiella pneumonia. Three cases with en-dophthalmitis lost their sight,and one with meningitis died. Conclusion IKLAS is common in people with diabetes,and it may be associated with multiple sites of metastasis of the body and lungs are the most involved organ.%目的 分析侵袭性肺炎克雷伯菌肝脓肿综合征患者的临床特征.方法 回顾性分析2010年1月至2017年10月中日友好医院收治的资料完整的确诊为肺炎克雷伯菌肝脓肿患者的临床资料.结果 符合侵袭性肺炎克雷伯菌肝脓肿综合征患者9例,男6例,女3例,年龄(56.77±10.28)岁.并发糖尿病4例,糖耐量异常1例,胆石症、慢性胆囊炎2例.单发脓肿7例,多发脓肿2例;血培养阳性8例.受累部位:肺部7例,眼部3例,皮肤软组织1例,关节1例,神经系统1例.血白细胞计数升高8例,丙氨酸氨基转移酶水平升高9例,降钙素原水平升高7例,肺炎克雷伯菌产超广谱 β内酰胺酶阳性1例.3例眼内炎患者均失明,1例并发脑膜炎患者死亡.结论 侵袭性肺炎克雷伯菌肝脓肿综合征常见于糖尿病人群,可伴机体多部位的转移感染灶,肺部为常见受累器官.