豚鼠耳炎诺卡菌肺病一例并文献复习  

Pulmonary nocardiosis:a case report and literature review

作　　者：沈轶[1] 张海[2] 李锋 李志夫[3] Shen Yi;Zhang Hai;Li Feng;Li Zhifu(Department of Intensive Care Unit,Shanghai Chest Hospital,Shanghai Chest Hospital of Shanghai Jiao Tong University,Shanghai 200030,China;Department of Pulmonary Medicine,Shanghai Chest Hospital,Shanghai Chest Hospital of Shanghai Jiao Tong University,Shanghai 200030,China;Department of Clinical Laboratory,Shanghai Chest Hospital,Shanghai Chest Hospital of Shanghai Jiao Tong University,Shanghai 200030,China)

机构地区：[1]上海市胸科医院上海交通大学附属胸科医院重症监护科,200030 [2]上海市胸科医院上海交通大学附属胸科医院呼吸内科,200030 [3]上海市胸科医院上海交通大学附属胸科医院检验科,200030

出　　处：《国际呼吸杂志》2020年第12期897-903,共7页International Journal of Respiration

基　　金：2019年度"上海交通大学'交大之星’计划医工交叉研究基金"(YG2019QNA51)。

摘　　要：目的探讨二代测序(NGS)技术在诺卡菌肺病诊断方面的价值。方法对1例肺炎患者的肺泡灌洗液行NGS检测,发现豚鼠耳炎诺卡菌感染,报告该例患者的临床资料、影像学特点、实验室检查和治疗情况,并在PubMed上以关键词"NGS"和"Nocardia otitidiscaviarum"搜索并复习文献。结果通过NGS快速检测诊断豚鼠耳炎诺卡菌肺病1例。豚鼠耳炎诺卡菌肺病无临床特异性,影像学检查显示肺部多发空洞或片状低密度阴影,诊断主要依据细菌学检验。作为目前最前沿的微生物检测技术,NGS可以更快速、更精确地鉴定致病菌。结论诺卡菌肺病是一种疗程长的少见病,NGS可以帮助诺卡菌肺病快速精准诊断。Objective To investigate the clinical value of next-generation sequencing(NGS)in diagnosis of pulmonary nocardiosis.Methods The NGS technology was used for the diagnosis of one case of pulmonary nocardiosis by testing the bronchoalveolar lavage fluid.The clinical feature,radiological characteristics,laboratory diagnosis and treatment were reported.A systematic literature review was performed for similar published cases in PubMed database,using the keywords"NGS"and"Nocardia otitidiscaviarum".Results One case of Nocardia otitidiscaviarum was diagnosed by NGS technology.Nocardiosis otitidiscaviarum had no specific clinical features.The computer tomography scan of chest showed multiple cavitary nodules and lamellar low-density shadow in both lungs.The most precise diagnosis could be provided by bacteriology examination.Compared to conventional method,as the cutting-edge technology,NGS could identify pathogenic bacteria faster and more accurately.Conclusions Pulmonary nocardiosis is a rarely specific infection which needs long-term treatment.The NGS technology can make a quick and accurate diagnosis of the disease.

关 键 词：豚鼠耳炎诺卡菌病 肺炎 二代测序 

分 类 号：R563.1[医药卫生—呼吸系统]