摘要
目的分析龋齿放线菌病的临床特点、诊断和治疗,提高临床医师对该病的认识。方法总结分析广东省人民医院收治的1例龋齿放线菌致脓胸的患者和来自1998-2018年文献报道的17例龋齿放线菌感染的病例资料。结果共纳入18例龋齿放线菌感染患者,男∶女=1∶1,年龄2~78岁,中位年龄为56.5岁,多伴有基础疾病(15/18),以心肺感染较常见(8/18),其中常见的临床表现为发热(7/8)、胸痛(5/8)、呼吸困难(4/8)和咳嗽(6/8);接受β内酰胺类治疗14例,12例同时采用外科手术辅助治疗;共治愈16例,治愈率88.9%。结论龋齿放线菌病罕见,临床及影像学表现无特异性,细菌培养及菌群鉴定是诊断该病的确凿依据。高剂量、长疗程青霉素治疗,结合有效的外科干预能取得良好的预后效果。
Objective To describe the clinical features,diagnosis and treatment of infections caused by Actinomyces odontolyticus. Methods A case of empyema due to Actinomyces odontolyticus was reported in Guangdong Provincial People's Hospital and 17 additional cases in literature report since 1998 were reviewed.Results Of the 18 cases of infections due to Actinomyces odontolyticus,male/female ratio was 1∶1,and the median age was 56.5 (range of 2-78) years old.Most (15/18) of these infections were found in patients with underlying disease.About half (8/18) of these infections were cardiorespiratory infection,the common clinical manifestation of which was fever (7/8),chest pain (5/8),dyspnea (4/8),and cough (6/8).14 patients received β-lactams antibiotic therapy,and 12 patients were supported with surgical treatment.The overall clinical cure rate was 88.9%. Conclusions Infection caused by Actinomyces odontolyticus is relatively infrequent.The clinical manifestation and imaging findings are not specific.Bacterial culture and identification are very important for confirming diagnosis.High dose and long-term penicillin therapy combined with surgical intervention can achieve good outcome.
作者
王蔚莎
刘素玲
黄爱伟
陈晓丽
侯铁英
WANG Weisha;LIU Suling;HUANG Aiwei;CHEN Xiaoli;HOU Tieying(Department of Laboratory Medicine,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2019年第4期357-362,共6页
Chinese Journal of Infection and Chemotherapy
关键词
放线菌病
龋齿放线菌
青霉素
actinomycosis
Actinomyces odontolyticus
penicillin
