Pasteurella multocida Infection with Bacteremia Mimicking Acute Coronary Syndrome

多殺性巴氏桿菌感染引發類急性冠心症

吳耿逸(Keng-Yi Wu) ； 郭正邦(Cheng-Bang Kuo) ； 陳裕峰(Yu-Feng Chen) ； 鍾國屏(Gwo-Ping Jong)

《內科學誌》 26卷5期 (2015/10) Pp. 299-302

摘要

一名43歲男性，有肝硬化病史及長期喝酒習慣，此次因右前臂遭狗隻咬傷併全身倦怠至急診求診，診斷為嚴重敗血症入駐內科加護中心，住院過程中因發生胸悶及冒冷汗症狀且併有心肌脢酵素異常，而緊急安排心導管檢查術，檢查結果並未發現有任何冠狀動脈異常狀況，但住院期間病人偶發有類似冠心症之症狀，直至血液培養結果證實為多殺性巴氏桿菌且接受適當抗生素治療，病患胸悶症狀明顯緩解。據推測此症狀可能為多殺性巴氏桿菌分泌之毒素直接影響心肌細胞收縮，致使病患因遭受該菌感染而產生類似急性冠心症病症。

並列摘要

Pasteurella multocida is found in the oral cavity and gastrointestinal tracts of domestic livestock, pets, and wild animals. It is uncommon in humans, but is associated with animal bites and scratches, and can serve as an opportunistic pathogen. Although infection in humans is rare; infected individuals may display symptoms of septicemia, septic arthritis, and pneumonia. We report the case of a cirrhotic patient, who was bitten by a dog and presented with septicemia, disseminated intravascular coagulation, and bleeding. He had symptoms of intermittent chest tightness with elevated cardiac enzymes levels under stable hemodynamically and was suspected to have acute coronary syndrome on hospitalization. Coronary artery angiography showed no abnormality. However, the above symptoms of the patient were relieved after administration of antibiotics. P. multocida septicemia mimicking acute coronary syndrome was highly suspected.

並列關鍵字

Acute coronary syndrome ； Pasteurella multocida ； Septicemia ； Toxin ； Vascular smooth muscle