骨髓及肺泡灌洗诊断播散性隐球菌患儿1例  

Bone marrow and alveolar lavage in diagnosis of a child with disseminated cryptococcosis

作　　者：李敏敏[1] 丁茸 陈华佳[1] 付亚林 彭淑梅[1] Li Minmin;Ding Rong;Chen Huajia;Fu Yalin;Peng Shumei(Departmentof Pediatrics,Guangdong Women's and Children's Hospital,Guangzhou 510000,China)

机构地区：[1]广东省妇幼保健院儿科,广州510000

出　　处：《国际医药卫生导报》2020年第22期3381-3384,共4页International Medicine and Health Guidance News

基　　金：广东省援疆科技(特派员)项目(粤科规财字[2018]145号)。

摘　　要：儿童播散性隐球菌的报道少,确诊主要依靠组织病理检查和病灶内脓液穿刺标本的病原学涂片和培养。笔者报道1例以长程发热、咳嗽为表现,CT表现双肺弥漫广泛密度增高影的患儿,经支气管镜肺泡灌洗液病原高通量基因检测到隐球菌核酸序列,并于骨髓培养发现新型隐球菌,予以两性霉素B脂质体及氟康唑治疗后效果良好,热退、咳嗽症状消失。启示我们对于慢性发热查因合并呼吸道症状等疑难病例患儿,可通过支气管镜肺泡灌洗液病原高通量基因检测尽快找到致病病原体,及早干预治疗。There are few reports about disseminated cryptococcosis in children.Its diagnosis depends mainly on histopathological examination,pathogenic smear,and culture of pus puncture specimens in the lesions.We reported a child with chronic fever and cough,CT manifestations of extensive diffuse density increase in both lungs,cryptococcal nucleic acid sequence detected bybronchoalveolar lavage fluid high-throughput sequencing(next-generation sequencing,NGS),and cryptococcusfoundin bone marrow culture.The girl was treated with amphotericin B liposome and fluconazole,and was good in outcome.The symptoms of fever and cough disappeared.For children with chronic fever due to complicated cases such as respiratory symptoms,we can find the pathogens as soon as possible through high-throughput genetic testing of bronchoscopic alveolar lavage fluidfor early intervention and treatment.

关 键 词：肺泡灌洗液 播散性隐球菌病 骨髓培养 高通量病原学基因检测 

分 类 号：R725.1[医药卫生—儿科]