病例報告：綠膿桿菌所引起之上海熱症候群，併壞疽性膿皰感染

Case Report: Shanghai Fever, a Syndrome Caused by Pseudomonas Aeruginosa, Complicated with Ecthyma Gangrenosum

上海熱(Shanghai fever)，初次報導於1918年，是含發燒、腹瀉、合併綠膿桿菌(Pseudomonas aeruginosa)敗血症之症候群。壞疽性膿皰(Ecthyma gangrenosum)常發生於免疫力不全患者，為綠膿桿菌造成的皮膚感染。本病例報告是一位五個月大的小男嬰，並無先天性免疫缺乏疾病，以發燒、咳嗽、水瀉以及特殊的皮膚病灶為初表現。血液培養和膿液培養均為綠膿桿菌，最終診斷為上海熱。靠著早期和適當的治療，包括積極的抗生素治療以及傷口引流，該男嬰完全復原且無留下任何後遺症。提醒臨床醫師，即便是健康幼兒，若出現有感染症狀與特異性的壞疽性膿皰皮膚疾病，須將此病列入鑑別，以免延誤治療。

Shanghai fever, first described in 1918, a syndrome was presented as fever, diarrhea, sepsis and culture of Pseudomonas aeruginosa from blood or another sterile body site. Ecthyma gangrenosum, often caused by P. aeruginosa, typically occurs in patients who are immunocompromised, can occasionally affects previously healthy children. We report a 5-month-old previously healthy boy who diagnosed Shanghai fever and presented with fever, productive cough, watery diarrhea and specific skin lesions on his body initially. Diagnosis was confirmed by blood and pus culture. With early and adequate treatment, including aggressive antimicrobial therapy, oxygen and fluid supplement and wound drainage, the patient recovered completely without any further complications.