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目的报告1例以乏力就诊，应用二代测序技术（NGS）确诊老年成人隐匿性自身免疫糖尿病（LADA）并发高毒力肺炎克雷伯菌（hvKP）致多器官感染患者的临床诊疗及转归，力求增加医务人员对hvKP及LADA的认识和了解，为临床提供该类患者的诊疗思路。方法回顾性分析1例初诊老年LADA并发高毒力肺炎克雷伯菌致多器官感染患者的病例资料、诊断过程、治疗方案及转归，并复习相关文献进行探讨。结果 经积极的强效抗感染、肝脓肿穿刺引流、控制血糖、营养支持等综合治疗，患者转归良好。结论hvKP侵袭性强，糖尿病患者是hvKP主要易感人群，快速明确诊断并加强引流联合强效的抗感染、营养支持、严格血糖控制等综合措施有助于改善患者预后，新型NGS病原体检测技术在高风险人群出现多器官严重感染时可帮助临床医师快速诊断病原菌。
Abstract：Objective To report the clinical diagnosis,treatment,and outcome of a patient with multiple organ infection caused by highly virulent Klebsiella pneumoniae(hvKP) in elderly adults with concealed autoimmune diabetes(LADA) diagnosed by secondgeneration sequencing technology(NGS),who was treated with fatigue,to increase the medical staff's knowledge and understanding of hvKP and LADA,and provide clinical ideas for the diagnosis and treatment of such patients. Methods A retrospective analysis was conducted on the case data,diagnostic process,treatment plan,and outcomes of a newly diagnosed elderly patient with LADA complicated by hvKP-induced multiorgan infection,and relevant literature was reviewed for discussion. Results After active and effective antiinfection,liver abscess puncture drainage,blood glucose control,nutritional support,and other comprehensive treatments,the patient's prognosis was good. Conclusion The hvKP is highly invasive,and patients with diabetes are the main susceptible population. Rapid and clear diagnosis and strengthening drainage combined with powerful anti-infection,nutritional support,strict blood glucose control,and other comprehensive measures will help improve the prognosis of patients. New NGS pathogen-detection technology can help clinicians quickly diagnose pathogens when a multiple-organ severe infection occurs in a high-risk population.
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基本信息:
DOI：10.16389/j.cnki.cn42-1737/n.2025.06.007
中图分类号:R563.1
引用信息:
[1]李霞,林梅.初诊老年LADA合并高毒力肺炎克雷伯菌致多器官感染1例报告及文献复习[J].江汉大学学报(自然科学版),2025,53(06):62-67.DOI:10.16389/j.cnki.cn42-1737/n.2025.06.007.
2025-12-16
2025-12-16