2型糖尿病反复合并类鼻疽伯克霍尔德杆菌脾脓肿一例报告

发布时间：2018-05-26 18:44

本文选题：糖尿病 + 型　；参考：《中国糖尿病杂志》2015年12期

【摘要】：报告1例T2DM渔民因发热先后2次入院,第1次入院血培养和影像学检查提示,类鼻疽伯克霍尔德杆菌败血症和肝脾内多发脓肿,予胰岛素强化控制血糖,予亚胺培南西司他丁联合复方磺胺甲恶唑(SMZ)抗感染1周后体温正常,24d后改为SMZ单药治疗,74d后停抗生素和降糖药物;8个月后再次发热,血培养阴性,CT示脾内脓肿。在胰岛素强化控制血糖同时,予头孢他啶联合SMZ抗感染,17d后改为SMZ单药抗感染,继续胰岛素控制血糖,6个月后停药,复查脾内脓肿体积缩小。血糖的良好控制和感染的积极控制是治疗的关键,在血糖控制不佳和机体免疫力低下时,脾内细菌可复燃。
[Abstract]:This paper reports a case of T2DM fisherman who was admitted to hospital for two times because of fever. The blood culture and imaging examination of the first admission showed that bacillus mallei septicemia and multiple abscesses in the liver and spleen were controlled by insulin intensive control. Imipenem cinnamastatin combined with compound sulfamethoxazolone (SMZ) was given. After 1 week, the body temperature was normal and changed to SMZ after 24 days. After 74 days of treatment, the antibiotics and hypoglycemic drugs were stopped. After 8 months, the fever was again, and the blood culture negative CT showed intrasplenic abscess. At the same time of insulin intensive control of blood glucose, ceftazidime combined with SMZ anti-infection was changed to SMZ single antibody infection after 17 days, insulin continued to control blood glucose, after 6 months, the volume of intrasplenic abscess was reduced. Good control of blood sugar and positive control of infection are the key to treatment. Bacteria in spleen can be rekindled when blood sugar control is poor and immunity is low.
【作者单位】：海南省人民医院内分泌科;
【分类号】：R587.2;R516

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