隐匿性肺放线菌病并异物1例  

Case report of occult pulmonary actinomycosis with foreign body

作　　者：易秋维 李晓楠[1] 王晓东[2] 曹娟[3] 鲍燕敏[1] Yi Qiuwei;Li Xiaonan;Wang Xiaodong;Cao Juan;Bao Yanmin(Department of Respiratory Medicine,Shenzhen Children′s Hospital,Shenzhen 518000,China;Department of Hematological Oncology,Shenzhen Children′s Hospital,Shenzhen 518000,China;Department of Pathology,Shenzhen Children′s Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市儿童医院呼吸科,深圳518000 [2]深圳市儿童医院血液肿瘤科,深圳518000 [3]深圳市儿童医院病理科,深圳518000

出　　处：《中华实用儿科临床杂志》2022年第8期634-637,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：深圳市医学重点学科建设经费(SZXK032)。

摘　　要：对深圳市儿童医院2018年9月收治的1例隐匿性肺放线菌病并异物患儿的临床资料进行回顾性分析,并检索复习相关文献资料。患儿,女,6岁9个月,因地中海贫血拟行造血干细胞移植,术前胸部CT平扫检查时发现右下肺片絮影,患儿无任何临床症状及肺部体征;予气管镜检查发现右肺下叶肉芽组织增生,气管镜下冷冻取出肉芽送检明确放线菌感染,且在肉芽内部发现包裹的数枚骨碎片。后予阿莫西林克拉维酸钾治疗0.5年后气管镜下表现及胸部CT情况均好转。肺放线菌病为少见的肺部感染性疾病,且儿童较成人更少见,常起病隐匿,且临床表现不典型,但儿童气道异物常见,为儿童感染提供了基础,在临床发现放线菌感染时,需要多思考感染原因,以防误诊误治。Clinical data of a case of occult pulmonary actinomycosis with foreign body admitted to Shenzhen Children′s Hospital were retrospectively analyzed,and the relevant literatures were retrieved and reviewed.A female patient aged 6 years and 9 months planned to receive hematopoietic stem cell transplantation due to thalassemia.During the plain chest CT examination before the transplantation,flakes of shadows were examined in the right lower lung.The child had no clinical symptoms or pulmonary signs.The granulation tissue hyperplasia of the right lower lobe was detected by tracheoscopy,which was harvested for examination under tracheoscopy,and actinomycete infection was confirmed.Several bone fragments were found wrapped inside the granulation.After 6 months of treatment with Amoxicillin and Clavulanate potassium,the tracheoscopic manifestations and chest CT were improved.Pulmonary actinomycosis is a rare pulmonary infectious disease,which is much rarer in children than adults,manifesting as an insidious onset and atypical clinical manifestations.However,foreign bodies in children′s airway are common,which is favorable to infection.In clinical detection of actinomycete infection,the cause of infection should be concerned to prevent misdiagnosis and mistreatment.

关 键 词：肺放线菌病 异物 儿童 

分 类 号：R725.6[医药卫生—儿科]