免疫抑制宿主肺皮疽奴卡菌病一例并文献复习  

Immunocompromised Host Pneumonia in an Nephrotic Syndrome Patient:a Case Report

作　　者：丁剑 吴峰 林涛 孟闯 周俊 DING Jian;WU Feng;LIN Tao;MENG Chuang;ZHOU Jun(Department of Pulmonary and Critical Care Medicine,The affiliated Hospital of Yangzhou University,Yangzhou 225009,Jiangsu Province,China;Yangzhou University Medical College,Yangzhou 225000,Jiangsu Province,China;Yangzhou University,Yangzhou 225000,Jiangsu Province,China)

机构地区：[1]扬州大学附属医院呼吸与危重症医学科,江苏扬州225009 [2]扬州大学医学院,江苏扬州225000 [3]扬州大学,江苏扬州225000

出　　处：《罕少疾病杂志》2024年第5期4-6,共3页Journal of Rare and Uncommon Diseases

基　　金：2023年扬州市级计划社会发展项目(YZ2023098,项目主持人:周俊);江苏省人兽共患病学重点实验室开放性课题(R2202项目主持人:周俊)。

摘　　要：目的提高对皮疽奴卡菌肺炎的临床表现、影像学特点、诊断、治疗及预后的认识和诊治水平。方法回顾性分析扬州大学附属医院2020年10月收治入院的1例皮疽奴卡菌肺炎的临床资料,并复习相关文献。结果41岁男性,有肾病综合征,主要表现为咳嗽、咯血,胸部CT示双肺多发结节伴有空洞,实验室检查结果显示白细胞数及中性粒细胞增高,血培养结果示皮疽奴卡菌,予以复方磺胺甲噁唑为基础的联合治疗,患者病情好转。结论皮疽奴卡菌肺炎在临床上较少见,大多发生于免疫缺陷的人群,临床资料及影像学无特异性,诊断有一定难度,主要依靠病原学检测,治疗上应予以给予复方磺胺甲噁唑为基础的联合治疗。Objective To improve the understanding of clinical features,imaging features,treatment and prognosis of nocardia farcinica pneumonia and the level of diagnosis and treatment.Methods The case of nocardia farcinica pneumonia admitted to Yangzhou University affiliated Hospital in october 2020 was analyzed retrospectively and disscussed in combination with the relevant literature.Results a 41-year-old man with nephrotic syndrome patient was referred to us for evaluation of cough hemoptysis and multiple nodules with cavities in both lungs.The laboratory laboratory examination results showed increased leucocyte and neutrophils count,and blood culture results showed nocardia Farcinicaa,and the patient was treated with compound trimethoprim-sulfamethoxazole based combination therapy.Then the patient's condition was improved gradually.Conclusions nocardia Farcinica Pneumonia is not common in clinical practice and mostly occurs in people with immunodeficiency.Pulmonary nocardiosis is without specific clinical and radiological feature and is difficult to diagnose.The definite diagnosis can be provided by bacteriology examination.Medications such as sulfamethoxazole may be required.

关 键 词：皮疽奴卡菌 肺炎 诊断 预后 

分 类 号：R563.1[医药卫生—呼吸系统]