全身性紅斑狼瘡病人合併Klebsiella Pneumoniae感染所致的咽旁膿瘍－－三個病例報告及文獻回顧

Parapharyngeal Abscess due to Klebsiella Pneumoniae Infection in Patients with SLE-- Three Cases Report and Literature Review

有三位患有全身性紅斑性狼瘡的年輕女性，分別因合併有腎炎或中樞神經系統病變，接受methylprednisolone脈衝療法。她們在接受這種類固醇治療一段時間後，在頸部都產生疼痛性的腫塊。經電腦斷層掃描及超音波檢查均顯示為一腫瘍產生，而且均延伸到舌骨附近，經施行膿瘍引流後，所培養出來的細菌都是Klebsiella pneumoniae，而且都對cefazoline及gentamicin敏感。因為Klebsiella pneumoniae的感染在臺灣的表現與其他地區不盡相同，而且狼瘍病人Klebsiella pneumoniae感染後所產生的咽旁膿瘍也從未在文獻上報導過，所以有此報告。

Three young females, with lupus nephropathy or CNS involvement, received methylprednisolone pulse therapy. They developed painful mass over their neck after steroid treatment. CT scan and sonogram disclosed abscess formation over carotid space with dissection to hyoid bone level. The drainage fluid culture yielded Klebsiella pneumoniae which were sensitive to cefazoline and gentamicin. Klebsiella pneumoniae infections in Taiwan were different from those in other countries, and the parapharyngeal abscess with K. pneumoniae infection in lupus patients has never been reported in the literature before.