符彬莎 黄梅会 王灵

[摘要]目的分析儿童类鼻疽伯克霍尔德氏菌脓毒症合并结核感染的临床特点。方法回顾分析1例儿童类鼻疽伯克霍尔德氏菌脓毒症合并结核感染的临床资料。结果患儿，男，9岁，以发热、头痛、呕吐为临床表现，既往结核感染不规则治疗，血培养发现类鼻疽伯克霍尔德氏菌，亚胺培南西司他丁钠联合利福平、异烟肼抗感染治疗有效，随访至今无复发。结论类鼻疽伯克霍尔德氏菌感染临床特点复杂多样，常规抗生素治疗效果欠佳，在儿童感染中少见，儿科医生应充分重视，早诊断，早治疗。

[关键词]类鼻疽伯克霍尔德菌;结核感染;小儿;脓毒症

[中图分类号] R529.9;R754.3 [文献标识码] A  [文章编号]2095-0616（2021）22-0231-04

Tuberculosis infection complicated with Burkholderiapseudomallei sepsis in a child： a case report

FUBinsha1 HUANGMeihui2 WANGLing

1.Department of Pediatrics， Hainan General Hospital， Hainan Affiliated Hospital of Hainan Medical University， Hainan， Haikou 570000， China;2.Department of Laboratory， Hainan General Hospital， Hainan Affiliated Hospital of Hainan Medical University， Hainan， Haikou 570000， China

[Abstract] Objective To analyze the clinical characteristics of Burkholderiapseudomallei sepsis complicated with tuberculosis infection in children. Methods The clinical data of a child with Burkholderiapseudomallei sepsis complicated with tuberculosis infection were analyzed retrospectively. Results The 9-year-old boy presented with fever， headache and vomiting， and he received irregular treatment previously for tuberculosis infection. Burkholderiapseudomallei were detected during blood culture. Imipenem and cilastatin sodium combined with rifampicin and isoniazid was effective in anti-infective treatment， and the child had no recurrence during the follow-up. Conclusion Burkholderiapseudomallei infection is rare in children with complex and diverse clinical characteristics， and the efficacy of conventional antibiotics is not good. Pediatricians should pay enough attention to early diagnosis and early treatment.

[Key words] Burkholderiapseudomallei; Tuberculosis infection; Child; Sepsis

類鼻疽病是由类鼻疽伯克霍尔德氏菌（burkholderiapseudomallei， BP）感染引起的一种人畜共患的地方性传染病，1912年泰国学者首次报道，最常见于热带及亚热带地区，而海南地区是我国主要疫源地[1]。 BP 在自然界存在于地方流行区的污水和土壤中，多见于稻田。海南是我国热带岛屿，气候温暖潮湿，雨水丰富，这决定了其为主要疫源地之一。类鼻疽病常表现为肺部感染，合并脓毒症、深浅器官脓肿等，如未及时诊断及治疗，病死率高。该病在儿童中少见报道[2-3]，现报道1例儿童 BP 脓毒症合并结核感染，以期提高对该病的认知。

1临床资料

1.1一般资料

患儿，男，9岁，因“发热4 d，伴头痛、呕吐3 d”以“脑炎？脓毒症？”收入我院儿科。患儿入院前4 d 无明显诱因下出现发热，体温最高达40℃，伴头痛、呕吐，曾在当地诊所给予头孢类药物治疗，效果欠佳。……