米氏克雷伯菌合并白色念珠菌感染致不明原因发热一例并文献复习

目的:探讨联合应用宏基因组学和培养组学技术对米氏克雷伯菌合并白色念珠菌感染所致不明原因发热患者的病原检测、分离和治疗措施。方法:分析济南市疾病预防控制中心联合山东大学齐鲁医院对2019年7月1日收治的1例米氏克雷伯菌合并白色念珠菌感染导致的不明原因发热患者的诊疗过程,并复习相关文献。结果:该患者主动脉层术后持续间断发热,经抗真菌治疗后效果不佳,经宏基因组学测序联合培养组学技术分离病原提示疑似米氏克雷伯菌合并白色念珠菌感染,调整使用头孢哌酮钠舒巴坦钠联合卡泊芬净抗感染治疗后,患者发热症状消失,实验室指标恢复正常后出院。结论:米氏克雷伯菌感染较少见,且易误诊为其他克雷伯菌,应用宏基因组学联合培养组学技术可尽早明确该病原所致感染,以进行针对性的抗感染治疗。

Report and literature review of a case with fever of unknown origin caused by Klebsiella michiganensis complicated with Candida Albicans infection

ObjectiveTo investigate the detection, isolation and treatment of a case with fever of unknown origin (FUO) caused by Klebsiella michiganensis and Candida Albicans infection by metagenomics and culturomics techniques. MethodsThe diagnosis and treatment process of a FUO patient with Klebsiella michiganensis and Candida Albicans infection admitted by Jinan Center for Disease Control and Prevention and Qilu Hospital of Shandong University on July 1st, 2019 was analyzed, and related literatures were reviewed. ResultsThe patient had a FUO after the operation of aortic continuous, but the effect was not well after antifungal treatment. Metagenomics sequencing and culturomics techniques showed that the patient was infected with Klebsiella michiganensis and Candida Albicans. After timely administration of sulperazon and caspofungin for anti-infection, the fever symptoms disappeared and laboratory indexes of the patient restored. ConclusionsKlebsiella michiganensis infection is relatively rare and easy to be misdiagnosed, metagenomics sequencing and culturomics techniques can be used to identify infection caused by Klebsiella michiganensis as soon as possible, and to carry out effective anti-infection treatment.