Септическая тромбоэмболия лёгочной артерии у пациентки с генерализованным сальмонеллёзом: клинический случай и метаанализ

Нетифоидные сальмонеллы представляют собой грамотрицательные бактерии, индуцирующие процесс Th1-опосредованного иммунитета. Они редко приводят к развитию септикопиемической формы инфекции, которая преимущественно встречается среди иммунокомпрометированных пациентов с дефектами одного из звеньев клеточно-индуцированного воспаления. Септическая тромбоэмболия лёгочной артерии (ТЭЛА) также является достаточно редким осложнением, при котором эмболы содержат микроорганизмы из первичных внелёгочных очагов. Представленный клинический случай пациентки с ТЭЛА и сальмонеллёзным сепсисом иллюстрирует редкое течение нетифоидного генерализованного сальмонеллёза, обусловленное наличием генетических полиморфизмов Asp299Gly и Thr399Ile в гене TLR4. Данное нарушение функции клеточно-опосредованного иммунитета обусловило развитие деструктивных изменений в лёгочной ткани, повышенное тромбообразование и генерализацию инфекционного процесса.

1. Ao T.T., Feasey N. A., Gordon M.A., Keddy K. H., Angulo F.J., Crump J.A. Global Burden of Invasive Nontyphoidal Salmonella Disease, 2010. Emer Infect Dis 2015; 21, 6: 941–949. doi:10.3201/eid2106.140999

2. Cheng W-L., Li C-W., Li M-C., Lee N-Y., Lee C-C., Ko W-C. Salmonella infective endocarditis. Microbiol Immunol Infect 2016; 49, 3: 313–320. doi: 10.1016/j.jmii.2015.02.659

3. Crump J. A., Sjölund-Karlsson M., Gordon M. A., Parrye Ch. M. Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections. Clin Microbiol Rev 2015; 28, 4: 901–937. doi: 10.1128/CMR.00002-15

4. Eng S-K., Pusparajah P., Mutalib N-S.A., Ser H-L., Chan K-G., Lee L-H. Salmonella: A review on pathogenesis, epidemiology and antibiotic resistance. Frontiers in Life Science. 2015; 8, 3: 1–10. doi:10.1080/21553769.2015.1051243

5. Ziakas P. D., Prodromou M. L., Khoury J. El., Zintzaras E., Mylonakis El. The Role of TLR4 896 A>G and 1196 C>T in Susceptibility to Infections: A Review and Meta-Analysis of Genetic Association Studies. Plos One 2013; 8, 11, e81047. doi: 10.1371/journal.pone.0081047

6. Ferwerda B., McCall M.B., Verheijen K., Kullberg B.-J., van der Ven A.J., van der Meer J.W. et al. Functional Consequences of Toll-like Receptor 4 Polymorphisms. Mol Med 2008; 14 (5–6): 346–352. doi:10.2119/2007-00135

7. Ye R., Zhao L., Wang C., Wu X., Yan H. Clinical characteristics of septic pulmonary embolism in adults: A systematic review. Respir Med 2014; 108, 1–8. http://dx.doi.org/10.1016/j.rmed.2013.10.012

8. Jiang J., Liang Q.L., Liu L.H., Cai C.Q., Du Z.Q., Kong J.L., Chen Y.Q. Septic pulmonary embolism in China: clinical features and analysis of prognostic factors for mortality in 98 cases. BMC Infect Dis 2019, 19: 1082 https://doi.org/10.1186/s12879-019-4672-1

9. Goswami U., Brenes J. A., Punjabi G.V., LeClaire M.M., Williams D. N. Associations and Outcomes of Septic Pulmonary Embolism. Open Respir Med 2014; 8, 1: 28–33. doi: 10.2174/1874306401408010028

10. Song X.Y., Li S., Cao J., Xu K., Huang H., Xu Z.J. Cardiac septic pulmonary embolism а retrospective analysis of 20 cases in a Chinese population. Medicine 2016 95: 25. http://dx.doi.org/10.1097/MD.0000000000003846.

11. http://www.ensembl.org/Homo_sapiens/Info/Index, дата обращения 02.02.2020

12. Konstantinides S.V., Meyer G., Becattini C. ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2019; 1–61.

13. Chou D-W., Wu S-L., Chung K-M., Han S-C., Cheung B.M-H. Septic pulmonary embolism requiring critical care: clinicoradiological spectrum, causative pathogens and outcomes causative pathogens and outcomes. Clinics 2016; 71 (10): 562–569. doi: 10.6061/clinics/2016(10)02

14. Allegrini D., Reposi S., Nocerino E., Pece A. Odontogenic orbital cellulitis associated with cavernous sinus thrombosis and pulmonary embolism: a case report. Allegrini et al. Med Case Reports 2017, 11: 164. doi: 10.1186/s13256-017-1309-0

15. Baidya A., Ganakumar V., Jadon R.S., Ranjan P., Manchanda S. R. Sood. Septic pulmonary emboli as a complication of peripheral venous cannula insertion. Drug Discov Ther 2018; 12 (2): 111–113. doi: 10.5582/ddt.2018.01016

16. Ben-Chetrit E., Weiner-Well Y., Katz D.E., Rosenman D., Munter G. VSDassociated Right Sided Infective Endocarditis Complicated by Septic Pulmonary Emboli, Am J Med Sci 2016; 352 (1): 107–108. http://dx.doi.org/10.1016/j.amjms.2016.03.007

17. Cheng F-Y., Su Y-J. Septic pulmonary emboli associated with klesiella pneumoniae epididymitis. J Emerg Med 2016; 50 (1): 23–24. http://dx.doi.org/10.1016/j.jemermed.2015.03.044

18. Makrides C., Symeonides M. Gemella morbillorum tricuspid valve endocarditis resulting in septic pulmonary emboli in a patient with intracranial hemorrhage. Intern J Cardiol 2015; 184: 769–771. http://dx.doi.org/10.1016/j.ijcard.2015.02.094

19. De Giorgi A., Fabbian F., Molino C., Misurati E., Tiseo R., Parisi C. et al. Pulmonary embolism and internal jugular vein thrombosis as evocative clues of Lemierre-s syndrome: A case report and review of the literature. World J Clin Cases 2017; 5 (3): 112–118 doi: http://dx.doi.org/10.12998/wjcc.v5.i3.112

20. De Smet K., Claus P-E., Alliet G., Simpelaere A., Desmet G. Lemierre-s syndrome: a case study with a short review of literature, Acta Clinica Belgica 2018; https://doi.org/10.1080/17843286.2018.1474614

21. Genez M. Septic pulmonary embolism associated with klebsiella spp. infection in a patient with previous ASD operation. Turk J Anaesthesiol Reanim 2019; 47 (6): 511–514. doi: 10.5152/TJAR.2019.39924

22. Alonso Ojeda Go´mez J. S., Carrillo Bayona J. A., Morales Cifuentes L. C. Septic pulmonary embolism secondary to Klebsiella pneumoniae epididymitis: case report and literature review. Case Rep Radiol 2019; 53. Article ID 5395090, https://doi.org/10.1155/2019/5395090

23. Ho V.T., Rothenberg K.A., McFarland G., Tran K., Aalami O.O. Septic pulmonary emboli from peripheral suppurative thrombophlebitis: a case report and literature review. Vascular Endovascular Surg XX(X). doi: 10.1177/1538574418779469

24. Hong G., Kim Y.S. Recurrent septic pulmonary embolism related to an implanted central venous access port device. Chin Med J 2018; 131: 3009–3011. doi: 10.4103/0366-6999.247196

25. Hong J-H., Lu Y-C., Wang S-M. Penile MSSA infection associated dry penile gangrene and pulmonary septic emboli. Am J Med Sci 2017; 353 (3): e5. http://dx.doi.org/10.1016/j.amjms.2016.05.006

26. Inchaustegui C. A., Wang K. Y., Teniola O., De Rosen V.L. Large septic pulmonary embolus complicating streptococcus mutans pulmonary valve endocarditis. Radiol Case 2018 Feb; 12 (2): 18–27. doi: 10.3941/jrcr.v12i2.3240

27. Jung J.S., Lee S.M., Kim H.J., Jang S-H., Lee J.W. A case of septic pulmonary embolism associated with renal abscess mimicking pulmonary metastases of renal malignancy. Ann Nucl Med 19 November 2013 / Accepted: 13 January 2014. doi: 10.1007/s12149-014-0811-3.

28. Kashihara E., Fujita K., Koyama H., Mio T. Septic pulmonary embolism complicated by pyogenic spondylitis and psoas abscesses in a patient with methicillin-sensitive Staphylococcus aureus bacteraemia. Oxford Medical Case Reports 2018; 12: 455–457. doi: 10.1093/omcr/omy108.

29. Kitajima S., Kaneko S., Wada T. Septic pulmonary embolism caused by internal shunt infection. Ther Apher Dial 2015; 19 (5): 525–526.

30. Lardo S., Ariane A., Chen K. Septic pulmonary embolism following appendectomy surgery. Acta Med Indones. 2015; 47 (3): 234–237.

31. Matsumoto K., Yamamoto W., Ohgusa E., Tanaka M., Maruta A., Ishigatsubo Y. et al. Disseminated Cunninghamella bertholletiae infection with septic pulmonary embolism after allogeneic bone marrow transplantation. Transpl Infect Dis 2014; 16: 304–306.

32. Morichika K., Nakachi S., Tomoyose T., Shimabukuro N., Tamaki K., Tedokon I. A rare case of septic pulmonary embolism caused by infectionassociated catheter removal in a patient with hodgkin-s lymphoma. Intern Med 2014; 53: 1215–1220. doi: 10.2169/internalmedicine.53.2092.

33. Nii T., Yoshikawa H., Okabe T., Tachibana I. Septic pulmonary and systemic embolism in tricuspid endocarditis. BMJ Case Rep 2014. doi:10.1136/bcr-2014-206569.

34. Paulis J., Tay E.T. Necrotizing fasciitis with pulmonary septic emboli following an infected insect bite. Yajem 2018. doi:10.1016/j.ajem.2018.08.034

35. Medina-Piñon I., Reyes-Mondragon A. L., Martinez-Resendez M. F., Camacho-Ortiz A. Septic pulmonary emboli and renal abscess caused by staphylococcus aureus in an hiv-infected patient. Case Reports Infect Dis 2018. Article ID 1460283, 3 pages. https://doi.org/10.1155/2018/1460283.

36. Prins W. B., Yilmaz A., Noordzij P. G. Bacterial endocarditis with septic pulmonary embolism due to pacemaker lead infection. Neth Heart J 2014; 22: 127–128. doi: 10.1007/s12471-012-0271-0.

37. Rahhal H., Campos F.P., Ferreira C.R., Felipe-Silva A. Lemierre-s syndrome due to intratumoral abscess of the uvula. Autopsy Case Rep [Internet] 2015; 5 (3): 11–20. http://dx.doi.org/10.4322/acr.2015.015

38. Reinders S., Bogaard K., Constant L.A., Knol R.J.J. A tortuous road for septic pulmonary emboli in left-sided endocarditis. Can J Cardiol 2014; 30: 1462. e3–e5 www.onlinecjc.ca.

39. Said S.A.M., Nijhuis R., Derks A., Droste H. Septic pulmonary embolism caused by infected pacemaker leads after replacement of a cardiac resynchronization therapy device. Am J Case Rep 2016; 17: 507–511. doi: 10.12659/AJCR.898009

40. Song X. Y., Li S., Cao J., Xu K., Huang H., Xu Z.J. Cardiac septic pulmonary embolism. A retrospective analysis of 20 cases in a Chinese population. Medicine 2016; 95: 25 (e3846). http://dx.doi.org/10.1097/MD.0000000000003846

41. Takano Y., Fukuda K., Takayasu H., Shinmura K., Koizumi G., Sasaiet M. et al. Liver abscessation and multiple septic pulmonary emboli associated with Lemierre-s syndrome: a case report. BMC Res Notes 2015; 8: 65. doi: 10.1186/s13104-015-1028-9.

42. Takeda K., Tanaka K., Kumamoto T., Nojiri K., Mori R., Taniguchi K. et al. Septic pulmonary embolism originated from subcutaneous abscess after living donor liver transplantation: a pitfall of postoperative management. Clin J Gastroenterol 2013; 6: 378–382. doi: 10.1007/s12328-013-0400-3/

43. Uluorman F., Tanriverdi Z., Sevinç C., Badak O., Çatalyürek H. An interesting septic embolism. Respir Med Case Rep 2014; 13: 54–56. http://dx.doi.org/10.1016/j.rmcr.2014.02.001.

44. Veras R. O., Barasuol L.L., de Lira C.P., Klostermann F. C., Müller L. S., Nercolini L. E. Lemierre syndrome: case report. J Vasc Bras 2018, Out. — Dez.; 17 (4): 337–340. https://doi.org/10.1590/1677-5449.002418.

45. Watanabe T., Yokoe M., Noguchi Y. Septic pulmonary embolism associated with periodontal disease: a case report and literature review. BMC Infect Dis 2019; 19: 74. https://doi.org/10.1186/s12879-019-3710-3.

46. Wu W., Ye S., Chen G.H. Right-sided infective mural endocarditis complicated by septic pulmonary embolism and cardiac tamponade caused by MSSA. Heart Lung 2018. https://doi.org/10.1016/j.hrtlng.2018.05.010.

47. Yao Z., Zheng J., Si Y., Wang W. Pneumocardia and septic pulmonary embolism due to nongas-forming liver abscess. A case report. Medicine 2018; 97: 45 (e13096). http://dx.doi.org/10.1097/MD.0000000000013096

48. Bastina M.L.T., Nevilleb N.R., Parsonsb R.E., Flannerya A.H., Tennanta S.J., Johnsonc C.A. An unusual case of Salmonella Enteritidis causing pneumonia, septic shock and multiple organ failure in an immunocompetent patient. IDCases 2016; 6: 85–89. doi: 10.1016/j.idcr.2016.10.004

49. Hitchcock J.R., Cook C.N., Bobat S., Ross E.A., Flores-Langarica A., Khan M., Dominguez-Medina C.C., Lax S., Carvalho-Gaspar M. Inflammation drives thrombosis after Salmonella infection via CLEC-2 on platelets. Clin Invest 2015; 125 (12): 4429–4446. doi:10.1172/JCI79070

50. MacMahon H., Naidich D.P., Goo V. et al. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology 2017; 284 (1): 228–243. doi: 10.1148/radiol.2017161659.