Pasteurella Multocida Bacteremia and Spontaneous Bacterial Peritonitis in Liver Cirrhotic Patient: 2 Case Reports

巴斯德氏菌和自發性腹膜炎在肝硬化的病人：兩例病例報告

許祐銓(Yu-Chiuan Hsu) ； 賴傳威(Chuan-Wei Lai) ； 許維邦(Wei-Pang Hsu) ； 許人文(Jen-Wen Hsu) ； 周思源(Sze-Yuan Chou)

《澄清醫護管理雜誌》 14卷3期 (2018/07) Pp. 25-29

摘要

Pasteurella multocida is a gram-negative coccobacillus that colonizes the upper respiratory tract of many animals, especially cats and dogs. It may lead to opportunistic infections in humans following bites or scratches by animals. In immunocompromised patients, such as those with liver cirrhosis, P. multocida infection is associated with soft tissue infections, septicemia, endocarditis, meningitis, pneumonia, and spontaneous bacterial peritonitis (SBP). SBP is a serious complication of liver cirrhosis, with a mortality rate of 10-15%. P. multocida infections are best treated with penicillin. Other antibiotics, such as ampicillin, second- and third-generation cephalosporins, doxycycline, carbapenems, sulfonamides, fluoroquinolones, and macrolides, may be equally effective. Clinicians should remain highly suspicious of P. multocida infections, especially in patients with liver cirrhosis and a history of animal contact.

關鍵字

Pasteurella multocida ； Bacteremia ； Spontaneous bacterial peritonitis ； Liver cirrhosis

並列摘要

巴斯德氏菌是一種革蘭氏陰性球桿菌定殖在許多動物的上呼吸道，特別是狗和貓。跟隨著動物咬傷或抓傷後，可引起人類的一種機會性感染。在免疫系統尚有缺損的患者，例如有肝硬化，它與軟組織感染，敗血症，心內膜炎，腦膜炎，肺炎和自發性細菌性腹膜炎（SBP）有相關。SBP是肝硬化的嚴重病發症之一，其死亡率高達10-15%。巴斯德氏菌感染最好用青黴素治療。其他抗生素如氨芐青黴素，第二代和第三代頭孢菌素，四環素，碳青黴烯類抗生素，磺胺類，氟諾酮類，紅黴素類可能同樣有治療效果。臨床醫師對於此疾病應保持高度懷疑，特別是有肝硬化病患以及有動物接觸史。

並列關鍵字

巴斯德氏菌 ； 菌血症 ； 自發性細菌性腹膜炎 ； 肝硬化