肾病综合征继发水生棒状杆菌肺部感染一例并文献复习  

Corynebacterium aquaticum infection： one case report and literature review

作　　者：安东善[1] 王树岐[1] 

机构地区：[1]吉林省人民医院呼吸科,长春130021

出　　处：《中华结核和呼吸杂志》2013年第12期959-962,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的 提高对水生棒状杆菌所致感染的认识,提高其诊断及治疗水平.方法 回顾性分析吉林省人民医院呼吸科1例经病理及肺组织细菌学培养、血培养、胸腔脓液培养确诊的水生棒状杆菌感染病例并进行相关文献复习.结果 患者男,39岁,因“发热、咳嗽、咳痰、右侧胸背部疼痛”10 d于2012年8月17日入院.入院前曾诊断为“肺炎”,静脉滴注广谱抗菌药物治疗无明显疗效.入院后在磁共振引导下经皮肺穿刺组织活检及肺组织细菌学培养、胸腔脓液培养以及血培养确诊为水生棒状杆菌肺炎合并脓胸及败血症.经胸腔脓液引流,静脉滴注万古霉素等治疗痊愈出院.到目前为止,国内外均未检索到水生棒状杆菌肺炎合并脓胸及败血症病例.结论 水生棒状杆菌肺炎合并脓胸及败血症罕见,确诊需要病理及肺组织细菌学培养、血液培养及胸腔脓液培养;胸腔冲洗引流及万古霉素静脉滴注治疗效果好.Objective To study the diagnosis and treatment of Corynebacterium aquaticum infection. Methods A retrospective analysis of one case of Corynebacterium aquaticum infection and literature review were conducted. Results A 39-year old male patient was admitted because of cough, sputum production,fever and right chest pain for 10 days. Broad-spectrum antibiotic therapy had been given in another hospital, but the patient＇s condition had deteriorated. Nuclear magnetic resonance-guided percutancous transthoracic needle aspiration and lung tissue, pleural fluid and blood culture were performed after admission to our hospital. Corynebacterium aquaticum was grown from the lung tissue, the blood and the pleural effusion. Therefore the diagnosis of Corynebacterium aquaticum pneumonia complicated with pyothorax and septicemia was confirmed. After draining of pleural pus and intravenous vancomycin therapy, the patient recovered and was discharged from hospital. After literature search, we did not find reports on Corynebacterium aquaticum pneumonia complicated with pyothorax and septicemia. Conclusions Corynebacterium aquaticum pneumonia complicated with pyothorax and septicemia is rare. The diagnosis could be confirmed by bacterial culture of lung tissue, pleural fluid and blood. Thoracic cavity draining and intravenous vancomycin are effective therapies for the disease.

关 键 词：水生棒状杆菌 肺炎 积脓 胸腔 

分 类 号：R473.5[医药卫生—护理学]