肺泡灌洗液宏基因组学测序诊断惠普尔养障体致肺脓肿伴肺炎1例
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南京医科大学附属常州市第二人民医院

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pulmonary abscess with pneumonia caused by Trophema whipplei was diagnosed with metagenomic next-generation sequencing in bronchoalveolar lavage fluid:a case report
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Yujia Shi

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    摘要:

    惠普尔养障体是一种革兰阳性杆菌,可引起慢性多系统感染性疾病,但肺部受累较罕见。我院收治一例肺脓肿伴有肺炎的患者,临床表现为咳嗽、咳痰,肺CT为空洞样病变,行支气管镜肺泡灌洗液宏基因测序检出惠普尔养障体,给予头孢曲松联合复方磺胺甲噁唑治疗后病情好转,出院后口服复方磺胺甲噁唑联合克拉霉素维持治疗,随访肺部病灶明显吸收;本文就该病例治疗过程进行报道。

    Abstract:

    Tropheryma whipplei is a Gram-positive bacterium that can cause chronic multi-system infectious diseases, but pulmonary involvement is rare. A patient with pulmonary abscess and pneumonia was admitted to our hospital. The clinical manifestations were cough and expectoration, and the lung CT showed cavernous lesions. Trophema whipplei was detected by metagene sequencing of bronchoalveolar lavage fluid. After treatment with ceftriaxone combined with sulfamethoxazole, the patient's condition improved fleetly. subsequently, sulfamethoxazole and clarithromycin were taken orally as maintenance therapy, the lung lesions were obviously absorbed during follow-up. This article reports the treatment process of this case.

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  • 收稿日期:2023-02-09
  • 最后修改日期:2023-04-23
  • 录用日期:2023-08-29
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