宏基因组二代测序诊断儿童耶氏肺孢子菌肺炎1例并文献复习  

Pneumocystis jirovecii pneumonia in children diagnosed by metagenomics next-generation sequencing:a case report and literature review

作　　者：林良康 杨凡 乔莉娜[1,2] 卢国艳 张海洋[1,2] LIN Liangkang;YANG Fan;QIAO Lina;LU Guoyan;ZHANG Haiyang(Department of Pediatric Intensive Care Unit,West China Second University Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西第二医院儿童重症医学科,成都610041 [2]出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《重庆医学》2023年第9期1352-1355,1362,共5页Chongqing medicine

基　　金：“十四五”国家重点研发计划项目(2021YFC2701705)。

摘　　要：目的探讨宏基因组二代测序(mNGS)技术在儿童耶氏肺孢子菌肺炎(PJP)诊断方面的价值,以期为早期诊断、治疗提供帮助。方法回顾性分析四川大学华西第二医院通过mNGS诊断的1例儿童耶氏肺孢子菌感染病例,并检索国内外数据库回顾文献,为诊断儿童PJP提供临床资料。结果男性婴儿,3月8天龄,以发热、气促、呼吸困难为主要表现,常规抗细菌感染治疗效果不佳,对肺泡灌洗液行mNGS检测发现耶氏肺孢子菌感染,予足量、足疗程复方磺胺甲噁唑治疗后好转。结论mNGS有助于诊断儿童耶氏肺孢子菌感染,供临床参考。Objective To explore the clinical value of metagenomics next-generation sequencing(mNGS)in the diagnosis of Pneumocystis jirovecii pneumonia(PJP),in order to providing assistance for early clinical diagnosis and treatment.Methods A case of children’s Pneumocystis jirovecii infection diagnosed by mNGS in West China Second University Hospital,Sichuan University was retrospectively analyzed,and literature reviews were conducted through searching domestic and foreign official databases,in order to provide clinical data for the diagnosis of PJP in children.Results This study reported a case of male infant,aged 3 months and 8 days,who was characterized by fever,shortness of breath and dyspnea.The conventional antibacterial treatment was not effective.Pneumocystis jirovecii infection was revealed by mNGS in the bronchoalveolar lavage fluid.At last the patient improved after sufficient sulfamethoxazole treatment.Conclusion mNGS is helpful for the detection of Pneumocystis jirovecii infection in children,which could provide clinical references.

关 键 词：耶氏肺孢子菌 肺炎 儿童 宏基因组二代测序 病例报道 

分 类 号：R725.6[医药卫生—儿科]