中国全科医学 ›› 2022, Vol. 25 ›› Issue (23): 2939-2941.DOI: 10.12114/j.issn.1007-9572.2022.0302

• 典型病例研究 • 上一篇    下一篇

儿童隐源性肝脓肿导致脓毒症合并非显性弥散性血管内凝血一例报道并文献复习

付强1,2,*(), 王婷1, 晏霞1   

  1. 1434020 湖北省荆州市,长江大学附属荆州医院儿科
    2434020 湖北省荆州市,长江大学儿科研究所
  • 收稿日期:2022-02-24 修回日期:2022-05-10 出版日期:2022-08-15 发布日期:2022-06-02
  • 通讯作者: 付强
  • 付强,王婷,晏霞. 儿童隐源性肝脓肿导致脓毒症合并非显性弥散性血管内凝血一例报道并文献复习[J]. 中国全科医学,2022,25(23):2939-2941,2946. [www.chinagp.net]
    作者贡献:付强提出论文写作思路、负责论文撰写、最终版本修订,对论文负责;王婷、晏霞进行病例资料收集,图表绘制等。
  • 基金资助:
    湖北省卫生计生委科研项目(WJ2018H210); 湖北省儿科联盟科学基金项目(HBPASF-2019-06)

Non-overt DIC in Cryptogenic Liver Abscess-associated Sepsis in Children: a Case Report and Literature Review

Qiang FU1,2,*(), Ting WANG1, Xia YAN1   

  1. 1Department of Pediatrics, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou 434020, China
    2Institute of Pediatrics, Yangtze University, Jingzhou 434020, China
  • Received:2022-02-24 Revised:2022-05-10 Published:2022-08-15 Online:2022-06-02
  • Contact: Qiang FU
  • About author:
    FU Q, WANG T, YAN X. Non-overt DIC in cryptogenic liver abscess-associated sepsis in children: a case report and literature review[J]. Chinese General Practice, 2022, 25 (23) : 2939-2941, 2946.

摘要: 儿童肝脓肿发病率低,查阅文献鲜有相关流行病学数据。肝脓肿可由胆管疾病、脓皮病、阑尾炎及创伤等导致,而隐源性肝脓肿病因不明,可仅表现为持续发热,无明显腹部不适,对早期诊断带来一定困难,延迟诊断可能发生脓毒症休克及弥散性血管内凝血(DIC),导致预后不良。本文报道1例耐甲氧西林金黄色葡萄球菌(MRSA)感染引起的隐源性肝脓肿导致脓毒症合并非显性DIC诊治过程。儿童隐源性肝脓肿是一种罕见的导致脓毒症的病因,不能确定感染灶时,除考虑血源性感染外,即使没有腹痛,也要将肝脓肿纳入鉴别诊断。

关键词: 肝脓肿, 隐源性肝脓肿, 脓毒症, 弥散性血管内凝血, 耐甲氧西林金黄色葡萄糖球菌, 儿童

Abstract:

Liver abscess is rare in children, which is caused by biliary tract disease, pyoderma, appendicitis or trauma. There is little available relevant epidemiological data. In particular, cryptogenic liver abscess is difficult to diagnose at the early stage due to unknown etiology, and few clinical manifestations such as persistent fever without obvious abdominal discomfort. A delayed diagnosis may be associated with septic shock and DIC, leading to poor prognosis. We reported the diagnosis and treatment of a child with non-overt DIC in sepsis associated with cryptogenic liver abscess induced by infection with methicillin-resistant Staphylococcus aureus. The case report and literature review indicate that cryptogenic liver abscess is a rare cause of sepsis in children, which should be considered as a potential causative factor of sepsis besides hematogenous infection when the site of infection could not be determined regardless of whether abdominal pain is present or not.

Key words: Liver abscess, Cryptogenic liver abscess, Sepsis, Disseminated intravascular coagulation, Methicillin-resistant Staphylococcus aureus, Child