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    Home > Active Ingredient News > Infection > Transient cerebral ischemic attack symbiotic infection with long nessamyelin blood flow infection reported 1 case

    Transient cerebral ischemic attack symbiotic infection with long nessamyelin blood flow infection reported 1 case

    • Last Update: 2020-07-12
    • Source: Internet
    • Author: User
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    Long Nesser bacteria for the Genus Nesser, Gram-negative cocci, is one of the normal flora of the upper respiratory tract? The bacteria is a condition-causing bacteria, resulting ininfectionrare situation and related case data is small, at present, only 2 cases of long naythriabacteria infection and are nitrite reduction subspecies , so the researchers on its pathogenic mechanism? Lack of understanding of the route of infection? According to statistics, long Naiser bacteria in the blood of infectious endocarditis patients isolated from the blood of the hospital, but recently in a case of clinicaldiagnosisfor "transient cerebral ischemia" patients in the blood multiple times isolated long Naitherbacteria subspecies, the patient did not appear obvious infectious endocarditis symptoms, with a certain research value, is reported as follows1 Case datapatient, male, 50 years old, due to "burst gait instability, dizziness 14d, fever 10d" was admitted to hospital on November 5, 2018, showing no obvious cause of gait instability? Hemp? Symptoms such as dizziness? The patient 10d before the cold? Fever, body temperature at 38.0 to 39.5 degrees C, body weakness, local hospital treatment (medication unknown) after the improvement, but still repeated fever? Admission examination: blood pressure 150/90mm Hg, heart rate 82 times / minute, breathing 16 times / minute, body temperature 39.4 degrees C, Shenqing, spiritual can, two lungs breathing clear, no dry and wet sound; nervous system: god clear? No eye shock? Double pupils and other large isospheres? Sensitive light reflection? What's the word? Unbiased? Feel the base of symmetry? Two-sided pathological signs negative? Electrocardiogram: sinus tachycardia, complete right beam conduction block, electroshaft right-hand bias of 155; heart color super: aortic valve diaphmo with minor stenosis (Figure 1); cranial brain magnetic resonance normal; chest CT: left upper lung tongue section a little cable; skull CT: flat sweep no obvious abnormality; cranial brain MRI? Mra? MRV check No exceptions? Blood-related examination: White blood cell count is 12.63 x 10 9/L? Percentage of neutrophils is 86.9%? Percentage of lymphocytes is 11.4%? Red blood cell count is 5.76 x 1012/L? hemoglobin is 171.0 g/L? platelet count is 376 x 10 9/L - Hypersensitivity C - Reaction egg white is 41.69mg/L? Red blood cell deposition rate is 23mm/h? Calcitonin was originally 2.31ng/mL, the rest of the test items are basically normal? From the second day of admission, the patient developed a cold fever, the highest body temperature of 39.4 degrees C, no gait instability? Dizzy? Cough? Coughing sputum? The frequency of urine? Urine rush? Urine pain? Abdominal pain? Depending on the patient's condition when the seizure, dizziness? Hematology and other bureau-based location signs, recovered within 24h, diagnosed as transient ischemic brainvascular diseasepossible? The disease is transient recurrent brain limitation ischemia leading to the corresponding brain blood supply region transient neurological function loss, bureau lesions? Shortness and recurrent are the main features of the disease, which are visually likened to "intermittent lameness of the brain"? Ginkgo Biloba Extract Injection? Antiplatelets and stable plaques such as adenosine cobaltamine and vitamin B 6? Reverse plaque medication and trace the cause of fever?2 pathogen examinationafter admission to hospital, did not use any drugs before collecting two sets of blood culture on the left and right, injecting oxygen demand and anaerobic blood culture bottles, continuous monitoring, culture 17h two bottles of oxygen demand, anaerobic bottles did not indicate growth signals? Turn a blood plate? Chocolate plate and McConkai plate culture (35 degrees C?5% CO2), and smeared for gram staining mirror test, see Grameen negative bacillus? 24h blood plate? Chocolate plate see diameter 1mm size, round? Yellow? Smooth? Translucent? Edge neat small colony growth (Figure 2), Grameen stainford for Grameen-negative bacillus (Figure 3), contactase test negative, oxygenase test positive, McConkaiplate plate did not see bacterial growth? The preparation of 3.0 mcEvoy turbidity of the bacteria suspension, Merie VITEK VITEK 2 NH card identified as the long Nesser long subspecies, biological code: 0632000000, identification matching degree of 99%; The Brucker MS mass spectrometer was identified as a subspecies of Long Nesser (1.950 min), and the results of the two methods were consistent? After 16S - rRNA molecular biology method sequencing, and sequencing results in Genbank BLAST comparison, showing the sequencing length of 2,588bp, with the long Nesseria long subspecies (M15910) of the same origin of 99%, the identification results are consistent with the previous method? After the patient in the cold war and collected 4 sets of blood culture sent for examination, many bottles of oxygen demand bottles are reported in 16 to 18h, also identified as the long Naiser bacteria long subspecies? In accordance with the Clinical Microbiology Manual, a drug sensitivity test was conducted, and the separation strain was used against cephalosporine? cephalosporine? Merobinan? Azithromycin? Minocycline? Are both plyconite and foenoniamine in vitro sensitivity? After azithromycin (0.5g/Qd) intravenous drip 3d, the body temperature returns to normal?3Long Nasser bacteria are divided into 3 subspecies: long subspecies? Desugar subspecies and nitrate reduction subspecies, can be distinguished by biochemical reactions? According to statistics, only two cases of long Nesser bacteria blood flow infection have been detected in china in recent years and are all nitrite reduction subspecies? In this case, the patient's blood culture detected the long subspecies of Long Nasser bacteria, which has a certain clinical research value, so the case is summarized as follows? Long Naiser bacteria for specialized aerobic bacteria, this example multi-bottle oxygen bottle sift, anaerobic culture 5d did not see bacteria growth, in line with this characteristic? It is often planted in human and animal upper respiratory tract, mostly pathogenic bacteria? The difference between the morphological and biochemical reactions of long Nesser bacteria and most Nisser bacteria is very easy to compare with the bacteria? Mora bacteria confusion, clinical microbial workers need to pay attention to? In addition to Long Nesser, the club-shaped Nisser bacteria found so far also include sweed Naisser and 105 group Nisser bacteria? The data on clinical infection caused by Changnaisser bacteria is small, which causes the actual laboratory workers to cause disease mechanism? Lack of understanding of the route of infection? According to the statistics, the patients infected with Long Nesser bacteria are mostly infected endocarditis patients and can be isolated from the heart valve of the dorcobacteria, the presence of heart valve dorma biological is the diagnosis of infectious endocarditis of the gold standard ? The patient color super prompt aortic valve dileaf malformation combined with slight stenosis, did not find a significant dorsey organism, this point is different from other countries and other domestic and foreign cases is also worth discussing and sharing, the specific mechanism to be further studied, but may guess that this is the infection of the bacteria 1 dangerous factor? At present, the clinical treatment effect of the blood flow infection of Changnesser bacteria is better, and the third generation of cephalosporins is used more? Penicillin or ampicillin/amoxicillin therapy, and the early period usually jointly qing damycin, treatment 4 to 7 weeks after the effect is better? In this case, with a ziacin vein drip, the body temperature is controlled faster? Although not sent for blood training again, but later follow-up found that the patient's body temperature did not rise again? The case gives clinical microbiologists a certain enlightenment, with the continuous updating and development of technology, the combination of a variety of diagnostic methods in the identification of rare bacteria there is real value? After this case quickly obtained the isolated strain information through conventional laboratory identification methods, the joint mass spectrometry technology and the popular molecular biology technology in recent years identified the pathogen, improved the accuracy of the identification of the bacteria, and provided the clinic with a more accurate laboratory report?Reference
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