- 期刊
Isolation of Eikenella Corrodens from Polymicrobial Hepatic Abscess: Report of One Case
Eikenella corrodens培養自多菌性肝膿瘍：一病例報告
摘要
Eikenella corrodens是一個罕見的肝膿瘍致病菌，尤其在小兒科此病患是第一例。此篇報告敘述一個包含Bacteroides fragilis，Streptococcus constellatus和Eikenella corrodens所引起的多菌性肝膿瘍，經由適當的抗生素治療三週及經皮膿瘍導管引流術後出院，仍有少數無菌性液體殘留，後經門診超音波追蹤確認肝膿瘍完全消失痊癒。我們在此討論此現象臨床上意義及Eikenella corrodens培養不易並具有獨特抗藥性的臨床特性，也提醒我們此種細菌存在之可能性。
並列摘要
Eikenella corrodens is a rare cause of hepatic abscess. We report a case of a hepatic abscess caused by (1) Bacteroides fragilis, (2) Streptococcus constellatus and (3) E. corrodens, which illustrates potential problems of antibiotic coverage due to the presence of Eikenella species. The infection followed an episode of acute gastroenteritis and the clinical course appeared indolent evolving over one week. Besides empirical antibiotics, initial percutaneous aspiration was performed and yielded pus which grew E. corrodens concomitantly with Streptococcus species. E. corrodens was sensitive to penicillin but resistant to clindamycin and metronidazole. But B. fragilis was resistant to penicillin. So the antibiotics were switched to amoxicillin/clavulanate. Unfortunately fever persisted and the abscess increased in size. Therefore echo-guided percutaneous drainage with pigtail catheter was installed. Fever subsided 5 days later. After 21 days treatment of antibiotics, the patient was discharged in good condition despite having some sterile fluid in the residual abscess cavity. Two months after discharge the follow-up echogram confirmed complete resolution of the residual abscess. This patient shows us the existence of E. corrodens in pediatric patients, especially when the hepatic abscess is very likely from the spread of an oral or abdominal infection.