嗜麦芽假单胞菌引起血型变异1例

Blood variation caused by Psendomonas maltophilia one case

1病例资料患儿,男,3个月,2013年3月25日入院,患儿10d前无明显诱因下出现发热,体温波动于39.0℃左右,无寒战惊厥,在儿童医院就诊,查血常规：白细胞23.4×109/L,中性粒细胞37.5%,淋巴细胞55.9%,CRP 66 mg/L。入院数天后出现咳嗽,为阵发性,无咳痰,无喘息,无时间规律。诊断为败血症、急性支气管肺炎。住院给予罗士芬、西迪林抗感染治疗（具体剂量不详）,体温持续不降,于19号改用美罗培南抗感染治疗1d体温即开始逐渐消退正常，3月28日查血型O型，RH（D）阳性，输血5项（HIV、HCV、TP、HBV、ALT）阴性，血气提示低氧血症，电解质提示血清钾3．39mmol／L，血清钠128mmol／L，血清氧93mmol／L;血常规白细胞7．55×109／L，中性粒细胞31．7％，淋巴细胞63．5％，血色素89g／L。

March 25,2013 admission,male,born three months,the diagnosis of sepsis,acute bronchial pneumonia.March 28 check blood type O,May 28 review of blood type B blood type,RH positive,a diagnosis of sepsis（Pseudomonas maltophilia）,acute bronchial pneumonia,oral ulcers（squirrel glucose bacteria growth after the review）.Blood is an inherited trait,is not easily changed,form B blood group antigens are blood group B genes under the control of,the precursor N-2-acyl glucosamine connect a D-D-galactose,and Stenotrophomonas Pseudomonas has explodedβ-galactose anhydride capacity,resulting in the synthesis of B blood type enzyme deletions cause red blood cell surface antigen B does not form properly,thereby causing blood group variation.