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作 者:王传海 李霜[1] 张建[1] 扈晓静 WANG Chuan-hai;LI Shuang;ZHANG Jian;HU Xiao-jing(Department of Respiratory and Critical Care Medicine,Shengli Oilfield Central Hospital,Dongying 257034,China)
机构地区:[1]胜利油田中心医院呼吸与危重症医学科,山东东营257034
出 处:《中国感染控制杂志》2022年第10期1019-1025,共7页Chinese Journal of Infection Control
基 金:山东省医药卫生科技发展计划项目(202103020493)。
摘 要:总结肺奴卡菌病合并曲霉感染的临床特点,提高对该疾病的诊治水平。报告2例肺奴卡菌病合并曲霉感染病例。以奴卡、曲霉组合为检索词,在万方数据库和中国知网检索到6篇中文文献;以nocardiosis、aspergillosis在PubMed、Web of Science数据库检索到17篇国外文献,进行文献复习。综合既往文献报道的病例及本组2例患者,共计27,其中男性15例,女性12例。除1例溺水者外,23例存在免疫受损,3例合并结构性肺病基础,临床特征和影像学表现均缺乏特异性;初始抗感染失败后,及时获取病原学证据,针对肺奴卡菌病和曲霉进行治疗后,大多数患者预后良好。肺奴卡菌病可能合并曲霉感染,易发生于免疫受损或结构性肺病患者,尤其是糖皮质激素使用者中,及早获取病原学结果,以获得早期诊断和治疗,对改善预后意义重大。To summarize the clinical characteristics of pulmonary nocardiosis complicated with Aspergillus infection and improve the diagnosis and treatment of this disease. Two cases of pulmonary nocardiosis complicated with Aspergillus infection were reported. With the combination of “Nocardia” and “Aspergillus” as the key words, 6 Chinese literatures were retrieved from Wanfang Database and China National Knowledge Infrastructure;17 foreign literatures were retrieved from PubMed and Web of Science with “nocardiosis” and “aspergillosis”. Combined with the previously reported literatures and 2 patients in this report, a total of 27 cases(15 males and 12 females) were analyzed, besides 1 patient after a near-drowning incident, 23 patients had immune impairment and the rest 3 patients had underlying structural pulmonary diseases. Their clinical characteristics and imaging manifestations were nonspecific. After failure in initial anti-infection, pathogenic evidence was obtained timely, most patients had good prognosis after treatment against pulmonary nocardiosis and Aspergillosis. Pulmonary nocardiosis may be associated with Aspergillus infection, which is prone to occur in patients with immune impairment or structural pulmonary diseases, especially among glucocorticoid users. Rapid pathogenic detection to obtain early diagnosis and treatment is of great importance to improve prognosis.
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