tailieunhanh - Báo cáo y học: " Vibrio parahemolyticus septicaemia in a liver transplant patient: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Vibrio parahemolyticus septicaemia in a liver transplant patient: a case report. | Fernando et al. Journal of Medical Case Reports 2011 5 171 http content 5 1 171 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Vibrio parahemolyticus septicaemia in a liver transplant patient a case report Rajeev R Fernando Sujatha Krishnan Morgan G Fairweather and Charles D Ericsson Abstract Introduction Vibrio parahemolyticus is the leading cause of vibrio-associated gastroenteritis in the United States of America usually related to poor food handling only rarely has it been reported to cause serious infections including sepsis and soft tissue infections. In contrast Vibrio vulnificus is a well-known cause of septicaemia especially in patients with cirrhosis. We present a patient with V. parahemolyticus sepsis who had an orthotic liver transplant in 2007 and was on immunosuppression for chronic rejection. Clinical suspicion driven by patient presentation travel to Gulf of Mexico and soft tissue infection resulted in early diagnosis and institution of appropriate antibiotic therapy. Case presentation A 48 year old Latin American man with a history of chronic kidney disease orthotic liver transplant in 2007 secondary to alcoholic end stage liver disease on immunosuppressants and chronic rejection presented to the emergency department with fever vomiting abdominal pain left lower extremity swelling and fluid filled blisters after a fishing trip in the Gulf of Mexico. Samples from the blister and blood grew V. parahemolyticus. The patient was successfully treated with ceftriaxone and ciprofloxacin. Conclusion Febrile patients with underlying liver disease and or immunosuppression should be interviewed regarding recent travel to a coastal area and seafood ingestion. If this history is obtained appropriate empiric antibiotics must be chosen. Patients with liver disease and or immunosuppresion should be counselled to avoid eating raw or undercooked molluscan shellfish. People can prevent Vibrio sepsis and wound infections by proper .

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