《Table 1Summary of laboratory investigations.》

  提示：宽带有限、当前游客访问压缩模式

本系列图表出处文件名：随高清版一同展现

《Hemorrhagic blisters in fulminant Aeromonas hydrophila bacteremia: Case report and literature review》

1. 获取 高清版本忘记账户？点击这里登录

1. 下载图表忘记账户？点击这里登录

A 49-year-old Taiwanese woman with a medical history of diabetes mellitus（DM）and ESRD，who had been undergoing regular hemodialysis（HD）for 8 years through an arteriovenous fistula over the right forearm at a rural hospital，was admitted to our facility.She was referred to our emergency department（ED）and presented with a one-day course of fever，dyspnea，hypotension，and fulminant hemorrhagic bullae covering her whole body.Upon arrival at the ED，the patient’s vital signs showed a respiratory rate of 34 breaths/min，heart rate of 124 beats/min，blood pressure of 76/48 mmHg and body temperature of 39.5℃.A physical examination revealed cardiopulmonary distress，pale conjunctiva，multiple hemorrhagic blisters，and a ruptured blister over the lower left leg（Figure 1）.Endotracheal intubation was implanted for both airway protection and ventilation using 100%oxygen.Laboratory investigations uncovered a white blood cell count of7 600/mm3 with segmented neutrophils of 92.6%，hemoglobin of8.2 g/dL，platelet counts of 121×103/mm3，blood urea nitrogen of 78 mg/dL，creatinine of 6.4 mg/dL，sodium of 138 mEq/L，potassium of 4.9 mEq/L，chloride of 98.0 mEq/L，calcium of 8.2mg/dL，albumin of 2.1 g/dL，glutamic-oxaloacetic transaminase of 108.0 U/L，glutamic-pyruvic transaminase of 72.0 U/L，alkaline phosphatase of 232.0 U/L，lactate dehydrogenase of 413.0U/L，lactate 77.5 mg/dL，C-reactive protein of 32.3 mg/dL，blood glucose of 23.0 mg/dL，prothrombin time of 16.2 s，and activated partial prothrombin time of 42.3 s.Arterial blood gas revealed a pH level of 7.061，PaO2 of 88 mmHg，PaCO2 of 30.2 mmHg，and an HCO3-of 15.3 mmol/L at 100%oxygen.The laboratory data is summarized in Table 1.A supine chest X-ray demonstrated cardiomegaly and an infiltration of both lower lung fields（Figure2）.However，the patient exhibited persistent shock（systolic blood pressure of around 60 mmHg）and expired in the ED despite an aggressive treatment of intravenous fluid，glucose water，ceftriaxone at 2 000 mg once daily，plus vancomycin at 1 000 mg twice daily，and inotropic agents with both norepinephrine and dopamine.Cultures of blood and blister fluid grew A.hydrophila three days later.