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首页> 外文期刊>Journal of Clinical Microbiology >Answer to photo quiz: Klebsiella pneumoniae bacteremia showing filamentous forms and spheroplasts due to the presence of subinhibitory concentrations of β-lactams
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Answer to photo quiz: Klebsiella pneumoniae bacteremia showing filamentous forms and spheroplasts due to the presence of subinhibitory concentrations of β-lactams

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A 21-year-old African-American female with a history of sickle cell anemia, multiple admissions for sickle cell crises, cholecystectomy 3 years prior, and avascular necrosis of the left hip 2 years prior presented with a fever and back pain. The patient had undergone a recent 10-day hospitalization with a diagnosis of Escherichia coli and Candida albicans infection of her peripherally inserted central catheter (PICC) line. The PICC line was removed, and the patient was treated with a 2-week course of intravenous ceftriaxone and fluconazole via a new PICC line. The patient now presented 12 days after discharge in sickle cell crisis, with generalized back pain and a fever of 102.2°F. The results for the physical examination were unremarkable except for severe hepatospleno-megaly. There were no signs or peripheral stigmata of endocarditis. The complete blood count was significant for leukocytosis (white blood cell count of 23,700 cells/mul, with a neutrophil level of 82) and anemia (hemoglobin level of 9.2 g/dl); the platelet count was within normal limits (345,000 platelets per mul). The results for the renal and liver function tests were all within normal limits except for a low albumin level (3.1 mg/dl). The chest X-ray examination showed no acute cardiopulmonary process.

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