一例鼠李糖乳杆菌感染性脓毒症病例报道
A Case of Sepsis Caused by Lactobacillus rhamnosus

感染的病原体呈现出越来越多样化和复杂化的趋势，特别是对于免疫功能缺陷的人群，如：恶性肿瘤、自身免疫缺陷、长期服用免疫抑制剂以及慢性病等患者，发生感染性疾病的风险水平更高，高危患者常常会存在罕见病原体感染的可能，造成了临床诊治的困难，严重影响着患者预后。我们报道了一例慢性肝硬化患者，因口服益生菌酸奶导致的血液感染鼠李糖乳杆菌造成脓毒症的案例。患者长期患有乙型病毒性肝炎、肝硬化，合并自身免疫性肝炎可能，自身免疫功能紊乱，在口服益生菌后出现高热、肝功能恶化，入院血培养结果提示鼠李糖乳杆菌感染，经护肝、抗菌治疗后病情控制，好转出院。对于慢性肝硬化、胃肠道损伤可能以及免疫力低下人群，应注意罕见病原体感染；肠道功能屏障下降人群，应慎用肠道益生菌制剂，警惕因使用益生菌制剂造成严重感染的可能。
The pathogens of infections show a trend of increasing diversity and complexity, and the level of risk of infectious diseases is higher, especially for immunocompromised populations, such as: patients with malignant tumors, autoimmune deficiencies, long-term use of immunosuppressive drugs, and chronic diseases. High-risk patients often have the possibility of infection by rare pathogens, which creates difficulties in clinical diagnosis and treatment and seriously affects patient prognosis. We report a case of sepsis due to blood infection with Lactobacillus rhamnosus in a patient with chronic cirrhosis caused by oral probiotic yogurt. The patient suffered from long-term viral hepatitis B, cirrhosis, combined with autoimmune hepatitis may, autoimmune dysfunction, after oral probiotics appeared high fever, liver function deterioration, admitted to the hospital blood culture results suggestive of Lactobacillus rhamnosus infection, after hepatoprotective and antibacterial treatment, the condition is controlled, and better discharged from the hospital. For people with chronic cirrhosis, possible gastrointestinal damage, and immunocompromised people, attention should be paid to rare pathogen infections; people with decreased intestinal functional barriers should use intestinal probiotic preparations with caution, and be wary of the possibility of serious infections caused by the use of probiotic preparations.