中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

肺奴卡菌病合并曲霉感染三例并文献复习

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目的总结肺奴卡菌病合并曲霉感染的临床特点,提高对该疾病的诊治水平。方法回顾性分析 2015 年 6 月至 2016 年 5 月中日友好医院收治的 3 例肺奴卡菌病合并曲霉感染患者的临床特点。以“奴卡菌”、“曲霉”组合为检索词,通过万方数据库和中国期刊全文数据库进行检索,均未检索到相关文献。以“nocardiosis”及“aspergillosis”在 PubMed 数据库检索到国外文献 9 篇,均为个案报道。结果本院 3 例患者均通过病原学检测明确为肺奴卡菌病,同时符合肺曲霉感染的临床诊断标准。其中 2 例病原学结果为烟曲霉,1 例病原学未检测到曲霉,但血清和肺泡灌洗液 GM 试验检测半乳甘露聚糖抗原水平显著升高。结论肺奴卡菌病合并曲霉感染易发生于免疫抑制患者,病原学检测对于诊断十分关键。

ObjectiveTo investigate the clinical features of patients who went through Nocardia co-infection with Aspergillus in lung.MethodsClinical data of 3 pulmonary nocardiosis patients complicated with aspergillosis from China-Japan Hospital during June 2015 and May 2016 were retrospectively analyzed. Nine related literatures found at PubMed were reviewed and they all were case report. No Chinese literature was found at Wanfang data and Chinese Journal Fulltext Database.ResultsAll of the 3 patients were diagnosed as pulmonary nocardiosis by etiological detection, at the same time meeting the diagnostic criteria of invasive pulmonary aspergillosis. Two cases were infected with Aspergillus fumigatus. Aspergillus was not detected in the third case, but the galactomannan of serum and bronchoalveolar lavage fluid significantly increased.ConclusionPulmonary nocardiosis complicated with aspergillosis trends to occur in immunocompromised patients, and pathogen detection is important for diagnosis.

关键词: 肺奴卡菌病; 侵袭性肺曲霉病; 支气管肺泡灌洗液; 免疫缺陷

Key words: Pulmonary nocardiosis; Invasive pulmonary aspergillosis; Bronchoalveolar lavage fluid; Immunocompromise

引用本文: 吴小静, 黄絮, 冯莹莹, 顾思超, 李敏. 肺奴卡菌病合并曲霉感染三例并文献复习. 中国呼吸与危重监护杂志, 2018, 17(4): 359-363. doi: 10.7507/1671-6205.201707014 复制

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