嬰兒的泌尿道枸櫞酸桿菌感染

Citrobacter Urinary Tract Infection in an Infant

廖賜寶(Tzu-Paio Liao)

《北市醫學雜誌》 3卷2期 (2006/02) Pp. 189-193

https://doi.org/10.6200/TCMJ.2006.3.2.11

摘要

枸櫞酸桿菌屬(Citrobacter)是造成菌血症、敗血症、肺炎、腦膜炎，腦膿瘍等病的致病菌種之一。但是造成孩童期泌尿道感染是不常見的，嬰兒期泌尿道感染更是罕見。本病例為枸櫞酸桿菌在嬰兒期造成泌尿道感染合併嚴重的膀胱輸尿管逆流，其臨床症狀有嬰兒發燒、食慾減少、情緒躁動不安，經急診看診後住院。理學檢查並無異常，尿液常規檢查為異常，尿液培養有枸櫞酸桿菌，腎臟超音波圖及排尿膀胱輸尿管排尿攝影檢查(VCUG)顯示有雙側中重度水腎併膀胱輸尿管迴流(grade V)，經7天的抗生素治療週期後出院，並轉介到馬偕小兒腎臟科繼續做追踪治療。本文提醒大家留意當嬰兒有泌尿道感染，尿液培養出枸櫞酸桿菌時，必須想到嬰兒可能併有先天性泌尿道構造異常。

關鍵字

枸櫞酸桿菌 ； 泌尿道感染 ； 膀胱輸尿管迴流 ； 嬰兒期

並列摘要

Citrobacter species have been described as the etiologic agents in cases of bacteremia, sepsis, pneumonia, meningitis, and brain abscess, but little is known of their role as a cause of urinary tract infection in infants. We report one case: citrobater species in urinary tract infection combing with underlying Gr V vesicoureteral reflux. This 1 m/o, female baby suffered from fever and poor feeding. She was initially brought to emergency room for help. Under the impression of Young Infant Fever, she was admitted to the pediatric ward for further evaluation and treatment. After admission, septic work was done. The urine analysis showed pyuria. Urine culture showed: Citrobacter species. Renal echo showed: Bilateral mild hydronephrosis, VCUG revealed: Bilateral Gr V vesicoureteral reflux with hydroureter. Antibiotic was used for 7 days. After discharge, she was referred to pediatric nephrogist & pediatric surgeon in MMH for further follow. The treatment of Citrobacter urinary tract infection was similar to that of other Gram-negative enteric organism. Further examination such as renal echography, voiding cystouretrography should be taken into consideration when citrobacter urinary tract infection was diagnosed during infancy.

並列關鍵字

crossing fire ceremony ； contact burn