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2020, vol. 25, br. 76, str. 54-57
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Sepsa izazvana bakterijom Granulicatella species - prikaz slučaja
Sepsis per Granulicatella species: A case report
aOpšta bolnica Užice, Odeljenje za infektivne i tropske bolesti, Užice bOpšta bolnica Užice, Mikrobiološka laboratorija, Užice
e-adresa: sladjanapj@gmail.com
Sažetak
Uvod: Bakterija Granulicatella species iz roda Abiotrophia poznata je kao nutritivna varijanta streptokoka. Normalno je stanovnik usne duplje, ali može uzrokovati invazivne infekcije, najčešće sepsu i bakterijski endokarditis, češće kod imunokompromitovanih osoba. Cilj istraživanja je bio da prikažemo slučaj teške kliničke forme sepse i plućnog apscesa kod bolesnika kod koga je u serumu identifikovana Granulicatella species. Prikaz slučaja Tokom decembra 2016. na Odeljenju za infektivne i tropske bolesti Opšte bolnice u Užicu lečen je 59-godišnji muškarac. Primljen je na lečenje zbog febrilnosti, malaksalosti, zamora i ikterusa. U istoriji ranijih bolesti dobijen je podatak da ima hipertenziju i diabetes mellitus i da je prekomerno konzumirao alkohol. Pri prijemu je bio febrilan, ikteričan, dehidriran, uz auskultatorni patološki nalaz na plućima desno. U laboratorijskim nalazima uočena je leukocitoza uz povišen C reaktivni protein, trombocitopenija, hiperbilirubinemija, povišene vrednosti azotnih materija i hipoproteinemija uz povišene vrednosti serumskih transaminaza. Rentgenski snimak pluća i kompjuterizovana tomografija su ukazali na plućni apsces, a ultrazvuk abdomena na hepatosplenomegaliju. U hemokulturi je izolovana Granulicatella species. Lečen je kombinacijom antibiotika širokog spektra. Uprkos tome, u daljem toku bolesti došlo je do nastanka septičkog šoka i letalnog ishoda. Zaključak: Granulicatella species normalno se može naći na mukoznim površinama gastrointestinalnog i urogenitalnog trakta. Pored toga, može izazvati teške invazivne infekcije. Lečenje takvih infekcija je teško, uz mogući smrtni ishod, posebno u slučaju drugih udruženih bolesti.
Abstract
Introduction: Granulicatella species, the genus Abiotrophia, were originally known as nutritionally variant streptococci. They are a normal component of the oral flora, but can be the cause of invasive infections, like sepsis, bacterial endocarditis, more often in immunodeficiency persons. The aim of the study was to present a case of severe clinical form of sepsis and pulmonary abscess in a patient with Granulicatella species in the serum. Case Outline: A 59-year-old man, was treated on Department for Infectious and Tropical Diseases, General Hospital Užice, in December 2016. He felt weakness, fatigue, had jaundice and fever. Patient's history included diabetes mellitus and excessive consumption of alcohol. On admission, he was febrile, icteric, dehydrated, with auscultation pathology on the right lung. In laboratory findings was leukocytosis, elevated C reactive protein, thrombocytopenia, hyperbilirubinemia, elevated nitrogen levels, hypoproteinemia and elevated serum transaminases. Lung X-ray and computed tomography indicated pulmonary abscess. Abdominal ultrasound showed hepatosplenomegaly and small ascites. Granulicatella species was isolated in hemoculture. Patient was treated with a combination of broad-spectrum antibiotics. Despite this, the onset of the disease resulted in septic shock and a lethal outcome. Conclusion: Granulicatella species is normally on the mucous surfaces of the gastrointestinal and urogenital tract. In addition, it can cause severe invasive infections. Treating such infections is difficult. In people with comorbidities, a fatal outcome is possible.
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