肺奴卡菌病合并曲霉感染三例并文献复习  

Pulmonary nocardiosis complicated with aspergillosis: three cases report and literature review

作　　者：吴小静[1] 黄絮[1] 冯莹莹[1] 顾思超[1] 李敏[1] WU Xiaojing;HUANG Xu;FENG Yingying;GU Sichao;LI Min(Department of Respiratory and Critical Care Medcine, China-Japan Friendship Hospital, Beijing 100029, P. R. China)

机构地区：[1]中日友好医院呼吸与危重症医学科,北京100029

出　　处：《中国呼吸与危重监护杂志》2018年第4期359-363,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：北京市科技计划课题首都临床特色应用研究与成果推广项目(Z161100000516116)

摘　　要：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Pub Med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。Objective To investigate the clinical features of patients who went through Nocardia co-infection with Aspergillus in lung. Methods Clinical 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 Pub Med were reviewed and they all were case report. No Chinese literature was found at Wanfang data and Chinese Journal Fulltext Database. Results All 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. Conclusion Pulmonary 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 

分 类 号：R519[医药卫生—内科学]