二代基因测序技术确诊嗜肺军团菌肺炎1例及文献回顾  

A Case of Legionella Pneumophila Pneumonia Confirmed by Metagenomics Next Generation Sequencing and Literature Review

作　　者：于金鹏 高巍[2] YU Jinpeng;GAO Wei(Linyi Maternal and Child Health Hospital,Linyi 276000,China;不详)

机构地区：[1]临沂市妇幼保健院,山东临沂276000 [2]山东大学第二医院

出　　处：《中外医学研究》2022年第16期153-156,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：嗜肺军团菌肺炎是以肺部感染为主要临床表现,可合并免疫功能低下等基础疾病,诊断困难,死亡率高。2020年12月山东大学第二医院重症医学科收治1例发热患者,该患者合并粒细胞缺乏症,且长期应用免疫抑制,出现以肺部感染为主要表现,病情迅速发展为呼吸衰竭。然而患者病原体未能明确,早期经验性治疗效果不佳,采用肺泡灌洗液二代基因测序技术(metagenomics next generation sequencing,mNGS)检查,发现嗜肺军团菌为致病菌,调整为大环内酯类联合喹诺酮类抗感染方案,随后患者体温出现平稳期,但因启动针对性治疗的时间延迟,最终病情难以控制而死亡。因此,对嗜肺军团菌肺炎的早期识别及治疗显得尤为重要。The main clinical manifestation of Legionella pneumophila pneumonia is pulmonary infection,which can be complicated with basic diseases such as low immune function,difficult to diagnose and high mortality.In December 2020,a patient with fever complicated with agranulocytosis and long-term immunosuppression was admitted to the Department of Critical Medicine of the Second Hospital of Shandong University.The patient presented pulmonary infection as the main manifestation and rapidly developed into respiratory failure.Pathogens in patients with failed to clear.However,the pathogen of the patient was not clear,and the early empiric treatment was not effective.After metagenomics next generation sequencing(mNGS)examination,Legionella pneumophila was found to be the pathogenic bacteria,adjusted to macrolides combined with quinolones anti-infection regimen,subsequently,the patient’s temperature levelled off.But by initiating targeted treatment time delay,patient finally died of illness is hard to control.Therefore,early identification and treatment of Legionella pneumophila pneumonia is particularly important.

关 键 词：嗜肺军团菌肺炎 二代基因测序技术 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]