Overview
Pseudomonas infection is a disease caused by the parasitization of the human body by Pseudomonas aeruginosa. Pseudomonas belongs to the Pseudomonas family, which includes a group of gram-stain-negative bacilli, and it is an opportunistic pathogen that often causes hospital-acquired infections. It is widely found in soil, water, dirt and air and grows well on all media. It is mainly categorized as Pseudomonas aeruginosa infection, Bacillus equinus infection, and nosocomial-like gangrene.
Etiology
Pseudomonas aeruginosa (Pseudomonas aeruginosa) is a common conditionally pathogenic bacterium among pseudomonas, when the resistance of human body decreases, it enters into the organism and can cause infections in the corresponding parts of the whole body, such as burned surfaces, respiratory, urinary tract, central nervous system, cornea and other infections as well as sepsis. Because Pseudomonas aeruginosa is naturally resistant to most antimicrobial drugs, it is difficult to treat, and at present, anti-Pseudomonas aeruginosa synthetic penicillin and third-generation cephalosporins can be used for clinical treatment. Pseudomonas equi (Bacillus nosocomialis) and Pseudomonas-like nosocomialis (Bacillus nosocomialis-like) can occasionally cause human morbidity. B. nosocomialis invades through skin lesions, the conjunctiva or the respiratory tract, while B. nosocomialis infects humans through direct contact, the respiratory tract, the gastrointestinal tract, or insect bites, etc. Both have a similar clinical presentation, and both can develop acute pulmonary infections, as well as systemic multilocational, multiorgan, and confined infections. Nosocomial gangrene lacks effective treatment, nosocomial gangrene can be tried tetracycline, chloramphenicol and other treatments, both of them can get more lasting immunity after the disease.
Symptoms
1. Pseudomonas aeruginosa infection
Symptoms of infection in various systems and parts, such as burned surface, respiratory tract, urinary tract, central nervous system, cornea and other infections.
(1) Sepsis manifested as fever, toxic shock, diffuse intravascular coagulation, and central gangrenous pustule.
(2) Septic meningitis manifested as high fever, vomiting, refusal to eat, crying and restlessness, and even convulsions.
(3) Respiratory tract infection The main pathological feature is necrotizing alveolar membrane changes. It may be complicated with abscess, pyothorax and bronchopleural fistula.
(4) Endocarditis There are three main types of clinical symptoms, i.e. systemic infection symptoms, cardiac symptoms, embolism and vascular symptoms.
(5) Gastrointestinal infections Newborns may present with diarrhea, fever, vomiting, dehydration and necrotizing small bowel colitis. In patients with leukopenic tumors may present with perirectal abscesses.
(6) Wound infection after burn is green or blue-green sticky secretion with sweet odor, and green pus with sweet odor under the scab is mostly Pseudomonas aeruginosa infection. Necrotic spots can be reproduced on the infected granulation wound.
(7) Other infections: peritonitis and urinary tract infection, corneal ulcer infection, ophthalmia, otitis externa, brain abscess, bone, joint and skin infection.
2. B. equi infection
The incubation period is 4-5 days in most cases, and there are also cases that last for months or years. The clinical manifestations are diversified and very similar to those of glanders. The disease can be divided into hidden infection, asymptomatic pulmonary infiltration, acute localized purulent infection, acute pulmonary infection, acute sepsis, chronic purulent infection and recurrent infection, etc., but there can be overlap between various types, which is difficult to be divided into distinct. Localized suppurative infections are manifested by nodule formation at skin breaks, enlarged lymph nodes in the drainage area and lymphangitis, often accompanied by fever and general malaise, which can quickly develop into acute sepsis.
Acute pulmonary infection is the most common type of infection in nosocomials, which can be primary or hematogenous disseminated pneumonia, with cough, chest pain and shortness of breath in addition to high fever and chills, and with symptoms disproportionate to the chest signs. This type may also progress to sepsis. Acute sepsis can be primary or secondary, and is the most serious clinical type of pyoderma gangrenosum. Some patients often die due to the rapid progression of the disease to the point where it is too late to resuscitate them.
3. Bacillus anthracis infection
This disease is mainly prevalent in Southeast Asia and is less common in other parts of the world. It causes a variety of diseases in humans, ranging from asymptomatic to acute toxic pneumonia or fatal sepsis.
Examination
Blood pathogenetic examination, positive cerebrospinal fluid and other secretions and excretions pathogenetic examination.
1. Microscopic examination of Pseudomonas aeruginosa bacteria
Pseudomonas aeruginosa is an elongated gram-negative bacillus with a length of 1.3-3.0m and a width of about 0.5m. It is often polymorphic and sporeless under static culture, and there is an elongated flagellum at one end of the bacterium, which is extremely active in movement. Can produce a variety of water-soluble pigments, which can make the pus become green pus pigment.
2. The secretion of B. equi is examined by smear.
Gram-negative B. equi can be found, and if it is stained with Lü’s basic merocyanine blue, the bacterium is stained with alternating shades of dark and light.
3. Serologic examination of anthrax-like bacteria
Indirect hemagglutination test or complement binding test with heat-resistant polysaccharide antigen or bacillus anthracis-like bacillus, strong positivity is often seen at the end of the week during the acute phase, and 90% of patients can be positive at 2-5 weeks.
Diagnosis
Diagnosis is made on the basis of etiology, history, clinical manifestations and laboratory tests.
Treatment
1. Treatment of Pseudomonas aeruginosa infection
Most of the commonly used antibiotics are resistant to Pseudomonas aeruginosa. Antibiotics can be selected according to the results of clinical and bacteriologic culture and drug sensitivity test. Commonly used drugs include anti-pseudomonas penicillin and cephalosporin, aminotrenan, aminoglycosides, fluoroquinolones and carbapenems, etc. However, in recent years, Pseudomonas aeruginosa’s sensitivity to most antimicrobial drugs has declined, which leads to difficulties in treatment, and clinically it is often used according to the specific situation.
2. Treatment of Pseudomonas aeruginosa infection
The primary damage should be surgically excised as soon as possible, and sulfonamides or antibiotics such as streptomycin and chloramphenicol should be applied.
3. Treatment of B. equi infection
Tetracycline, chloramphenicol, streptomycin and sulfonamides are sensitive antibiotics.
Questions you may be concerned about
Pseudomonas Mendoza infection
Pseudomonas Mendoza infection can be improved by medication, physical therapy, and general treatment.
1. Drug treatment: the disease is an infectious disease, patients need to follow the doctor’s instructions to use antibiotics sensitive to bacteria for treatment, common drugs mainly include cefoperazone, ciprofloxacin, etc., can effectively inhibit the inflammatory response.
2. Physical therapy: if the patient’s temperature does not exceed 38.5 ℃, you can use warm water to wipe the body, you can also use medical fever patch, can achieve the effect of physical cooling; if there is a persistent high fever, you can also use ibuprofen and other drugs that have the effect of reducing fever.
3. General treatment: usually need to drink more water, promote the body’s metabolism, but also need to eat more dietary fiber-rich fruits and vegetables, such as oranges, carrots, etc., to replenish the body’s vitamins needed to improve immunity.
During the treatment period, you need to pay attention to your own recovery, you also need to visit the infection department of the hospital on a regular basis, all drugs should be used under the guidance of the doctor.