经肺泡灌洗液高通量测序诊断婴儿肺孢子菌肺炎1例并文献复习  

A case of pneumocystis pneumonia in infants diagnosed by next generation sequencing of BALF and literature review

作　　者：朱其国 袁林[1] 周峻荔 康小俊 白定珍 王立波 ZHU Qiguo;YUAN Lin;ZHOU Junli;KANG Xiaojun;BAI Dingzhen;WANG Libo(Respiratory Department of Xiamen Children's Hospital,Children’s Hospital of Fudan University Xiamen Branch,Xiamen 361006,Fujian,China;Respiratory Department of Children’s Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]厦门市儿童医院复旦大学附属儿科医院厦门分院呼吸科,福建厦门361006 [2]复旦大学附属儿科医院呼吸科,上海201100

出　　处：《临床儿科杂志》2020年第5期370-373,共4页Journal of Clinical Pediatrics

基　　金：厦门市儿童医院青年科研项目(No.CHP-2019-YRF-0026)。

摘　　要：目的探讨肺孢子菌肺炎的病因、临床表现、病原学诊断和治疗。方法回顾分析1例肺孢子菌肺炎患儿的临床资料。结果患儿,男,2个月20天,临床表现为慢性咳嗽、气促、烦躁、低氧血症;肺部影像呈双肺弥漫性浸润改变;经支气管镜术取肺泡灌洗液进行宏基因高通量测序后证实为肺孢子菌感染。确诊后予甲氧苄胺嘧啶-磺胺甲噁唑(TMPSMZ)治疗,临床症状基本消失,肺部CT明显好转。结论肺泡灌洗液行宏基因高通量测序可诊断肺孢子菌肺炎。Objective To investigate the etiology,clinical manifestations,etiological diagnosis and treatment of pneumocystis pneumonia.Methods The clinical data of a child with pneumocystis pneumonia were retrospectively analyzed.Results A male infant,aged 2 months and 20 days,presented with chronic cough,shortness of breath,irritability,and hypoxemia.Pulmonary imaging showed diffuse infiltration of both lungs.The metagenomic next-generation sequencing of bronchoalveolar lavage fluid by bronchoscope confirmed pneumocystis infection.Clinical symptoms of the patient disappeared and exudation of lung CT absorbed after treatment with trimethoprim-sulfamethoxazole.Conclusion Infants should be alerted to pneumocystis pneumonia when having recurrent cough,shortness of breath,hypoxemia and diffuse infiltration in both lungs.Metagenomic next-generation sequencing with bronchoscopic alveolar lavage fluid is a better method for pathogenic diagnosis of pneumocystis pneumonia.

关 键 词：婴儿 肺孢子菌肺炎 肺泡灌洗液 宏基因高通量测序 

分 类 号：R725.6[医药卫生—儿科]