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NEJM：播散性淋球菌感染-病例报道

2019-04-18 xing.T 网络

播散性淋球菌感染皮疹
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鉴于高度怀疑播散性淋球菌感染，该患者开始使用头孢曲松和阿奇霉素治疗。血培养生长革兰氏阴性双球菌，其被鉴定为淋病奈瑟氏球菌，证实了诊断。

患者为一名20岁的女性，因手臂、腿、躯干和头皮皮疹而到急诊就诊，就诊当天早晨爆发了这种皮疹。她还报告了全身肌肉疼痛，发热和两个脚踝疼痛。两周前，患者与一位没有屏障保护的新伴侣进行了阴道性交。

体格检查时，手腕附近和手指（如图A所示）以及躯干、头皮和两个脚踝上可见明显的红斑脓疱。右脚踝处有被动运动，伴有两个脚踝肌腱的腱鞘炎，轻度肿胀和疼痛。


鉴于高度怀疑播散性淋球菌感染，该患者开始使用头孢曲松和阿奇霉素治疗。血培养生长革兰氏阴性双球菌（如图B所示），其被鉴定为淋病奈瑟氏球菌，证实了诊断。

该患者的症状因抗生素治疗而减轻。在3个月的随访中，患者感觉良好，没有皮肤病变或关节疼痛复发。 
 
原始出处：

Stephanie Florez-Pollack,et al.Disseminated Gonococcal Infection.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1811120

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    2019-09-25 clmlylxy

    #播散性#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1769423, encodeId=eeda1e69423bb, content=<a href='/topic/show?id=3ca75e0059d' target=_blank style='color:#2F92EE;'>#播散性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57005, encryptionId=3ca75e0059d, topicName=播散性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c90838047642, createdName=clmlylxy, createdTime=Wed Sep 25 02:03:00 CST 2019, time=2019-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1967655, encodeId=35a7196e6550a, content=<a href='/topic/show?id=ed036604309' target=_blank style='color:#2F92EE;'>#淋球菌感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66043, encryptionId=ed036604309, topicName=淋球菌感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Jun 11 21:03:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369772, encodeId=bc061369e7205, content=<a href='/topic/show?id=828966041d2' target=_blank style='color:#2F92EE;'>#淋球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66041, encryptionId=828966041d2, topicName=淋球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Fri Apr 19 23:03:00 CST 2019, time=2019-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034790, encodeId=48061034e9020, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 18 11:03:00 CST 2019, time=2019-04-18, status=1, ipAttribution=)]
    2019-06-11 柳叶一刀

    #淋球菌感染#

    0

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    2019-04-19 xzw113

    #淋球菌#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1769423, encodeId=eeda1e69423bb, content=<a href='/topic/show?id=3ca75e0059d' target=_blank style='color:#2F92EE;'>#播散性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57005, encryptionId=3ca75e0059d, topicName=播散性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c90838047642, createdName=clmlylxy, createdTime=Wed Sep 25 02:03:00 CST 2019, time=2019-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1967655, encodeId=35a7196e6550a, content=<a href='/topic/show?id=ed036604309' target=_blank style='color:#2F92EE;'>#淋球菌感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66043, encryptionId=ed036604309, topicName=淋球菌感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Jun 11 21:03:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369772, encodeId=bc061369e7205, content=<a href='/topic/show?id=828966041d2' target=_blank style='color:#2F92EE;'>#淋球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66041, encryptionId=828966041d2, topicName=淋球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Fri Apr 19 23:03:00 CST 2019, time=2019-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034790, encodeId=48061034e9020, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Apr 18 11:03:00 CST 2019, time=2019-04-18, status=1, ipAttribution=)]
    2019-04-18 旺医

    顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

    0