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自從上次一個open TB的病人轉去9B，blood culture yielded anaerobic GNB (Propionibacterium acnes)，後來在我值完班正要PM的時候hematemesis，shock，兩天後星期日expire後，我就對anerobic bacteremia有種不科學的恐懼。

之前HHS septic shock的慘痛案例，加上跟覲瑄聊天得到F/S的變化其實有玄機，上禮拜看F/S一直覺得怪怪的，我心裡就對這個奶奶有不祥的預感，果然今天下午轉ICU了Q口Q

血糖偶爾一兩天高到三百多，一直打RI，但又有幾天只有八九十，真的很不尋常，blood culture yielded anaerobic GNB (Prevotella disiens)，又是一個沒看過、讓人頭大的細菌，查了一下正常存在在人體口腔、腸道、及泌尿生殖道，但也查不出奶奶到底細菌來自何方...。

希望可以順利度過難關啊！我不想再為我的病人流淚了嗚嗚QQQQ

Infections caused by anaerobic bacteria are common and may be serious and life-threatening. Anaerobes are the predominant components of the bacterial flora of normal human skin and mucous membranes (1), and they are a common cause of bacterial infections of endogenous origin. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719496/)

Clinical Significance of Propionibacterium acnes Recovered from Blood Cultures: Analysis of 524 Episode (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122867/)

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719496/ )

Epidemiological characteristics of infections caused by Bacteroides, Prevotella and Fusobacterium species: a prospective observational study.(https://www.ncbi.nlm.nih.gov/pubmed/21664284 )