支气管扩张伴圣乔治教堂诺卡菌肺部感染1例并文献复习  

Pulmonary infection caused by Nocardia cyriacigeorgica in a patient with bronchiectasis:a case report and literature review

作　　者：陆晓芳 朱园园 潘畅 LU Xiaofang;ZHU Yuanyuan;PAN Chang(The Department of General Medicine of the Community Health Service Center,Jiangqiao Town,Jiading District,Shanghai 201803,China;The Department of General Medicine of the Tongren Hospital,Shanghai Jiaotong Univerity School of Medicine 200336,China;The Department of Occupational Diseases of the Fire And Rescue Hospital,Shanghai 200443,China)

机构地区：[1]上海市嘉定区江桥镇社区卫生服务中心全科,上海201803 [2]上海交通大学医学院附属同仁医院全科,上海200336 [3]上海消防医院职业病科,上海200443

出　　处：《中国真菌学杂志》2024年第6期623-628,共6页Chinese Journal of Mycology

摘　　要：报道1例64岁女性同时存在支气管扩张症、陈旧性肺结核和系统性红斑狼疮的圣乔治教堂诺卡菌(Nocardia cyriacigeorgica,N.cyriacigeorgica)肺部感染患者。临床主要表现为反复咳嗽、咳痰,初期结合患者胸部CT,考虑肺部感染,但予以经验性抗生素治疗病情无好转,入院后予查痰涂片、痰培养、真菌培养等均为阴性结果,后行气管镜检查,肺泡灌洗液经宏基因组二代测序检出致病菌为圣乔治教堂诺卡菌,患者应用复方磺胺甲恶唑联合氨苄西林钠舒巴坦钠抗感染治疗后好转出院,出院后继续服用复方磺胺甲恶唑片及左氧氟沙星片,约2个月后复查胸部CT病灶明显吸收。To report a 64-year-old female patient with pulmonary infection caused by Nocardia cyriacigeorgica,who also had bronchiectasis,the history of pulmonary tuberculosis,and systemic lupus erythematosus(SLE).Her main clinical manifestations were repeated coughand expectoration.At the initial stage,combined with the patient's chest CT,pulmonary infection was considered,but the patient's condition did not improve after the antibiotics treatment.The results of sputum smear,sputum culture,fungal culture,and other examinations were all negative.Tracheoscopy was performed,and the patient's lavage fluid was subjected to mNGS to detect the pathogen as N.cyriacigeorgica.After treatment with TMP-SMX and ampicillin sodium and sulbactam sodium,the patient recovered and discharged from hospital.After discharge,continue to take TMP-SMX and levofloxacin tablets.After more than 2 months of re-examination,the lesion of chest CT showed significant absorption.

关 键 词：支气管扩张 圣乔治教堂诺卡菌 诺卡菌病 肺部感染 

分 类 号：R519.1[医药卫生—内科学]