NEJM:播散性淋球菌感染-病例报道

2019-04-18 xing.T 网络

鉴于高度怀疑播散性淋球菌感染,该患者开始使用头孢曲松和阿奇霉素治疗。血培养生长革兰氏阴性双球菌,其被鉴定为淋病奈瑟氏球菌,证实了诊断。

患者为一名20岁的女性,因手臂、腿、躯干和头皮皮疹而到急诊就诊,就诊当天早晨爆发了这种皮疹。她还报告了全身肌肉疼痛,发热和两个脚踝疼痛。两周前,患者与一位没有屏障保护的新伴侣进行了阴道性交。

体格检查时,手腕附近和手指(如图A所示)以及躯干、头皮和两个脚踝上可见明显的红斑脓疱。右脚踝处有被动运动,伴有两个脚踝肌腱的腱鞘炎,轻度肿胀和疼痛。


鉴于高度怀疑播散性淋球菌感染,该患者开始使用头孢曲松和阿奇霉素治疗。血培养生长革兰氏阴性双球菌(如图B所示),其被鉴定为淋病奈瑟氏球菌,证实了诊断

该患者的症状因抗生素治疗而减轻。在3个月的随访中,患者感觉良好,没有皮肤病变或关节疼痛复发。 
 
原始出处:

Stephanie Florez-Pollack,et al.Disseminated Gonococcal Infection.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1811120

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    2019-09-25 clmlylxy
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    2019-04-19 xzw113
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    2019-04-18 旺医

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