唾液链球菌肺炎相关性气胸:病例报告和文献综述。

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES
Zhuo Chen, Keheng Xiang, Kaijin Wang, Bicui Liu
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引用次数: 0

摘要

背景:唾液链球菌是一种机会性病原体,迄今为止尚未有唾液链球菌肺炎病例的报道。气胸通常继发于气管或食管损伤,作为肺炎的并发症非常罕见。我们报告了一例唾液链球菌肺炎并发气胸的病例,旨在提高临床医生对罕见病原体和肺炎罕见并发症的认识:患者是一名 36 岁的男性,因持续咳嗽、咳痰一周,并伴有前一天才出现的咽喉痛而就诊。胸部计算机断层扫描(CT)显示,左下叶存在气胸和阻塞性肺不张。通过支气管肺泡灌洗液元基因组新一代测序(mNGS)以及涂片和培养分析,最终确定了唾液链球菌感染。作为抗感染治疗方案的一部分,患者接受了为期七天的阿莫西林-克拉维酸钾静脉注射。鉴于患者的呼吸和循环系统稳定,没有必要进行插管引流手术。治疗后,患者的临床症状明显好转。随后的胸部 CT 扫描显示,左下肺再次扩张,气胸几乎完全消退:结论:引起肺炎的病原体有很多。在关注常见病原体的同时,也不能忽视罕见病原体。在考虑罕见病原体感染时,建议及时进行支气管镜检查,并将支气管肺泡灌洗液送检 mNGS,以提高病原体的检出率。在肺炎的诊断和治疗过程中,警惕罕见并发症至关重要。当患者出现呼吸困难或皮下气肿等症状时,建议立即进行胸部 CT 扫描以排除气胸。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Streptococcus salivarius pneumonia-associated pneumomediastinum: a case report and literature review.

Background: Streptococcus salivarius is an opportunistic pathogen, and there have been no reported cases of Streptococcus salivarius pneumonia to date. Pneumomediastinum is usually secondary to tracheal or esophageal injury and is very rare as a complication of pneumonia. We report a case of Streptococcus salivarius pneumonia complicated by pneumomediastinum, aiming to enhance clinicians' awareness of rare pathogens and uncommon complications in pneumonia.

Case presentation: The patient, a 36-year-old male, presented with a persistent cough and sputum production for one week, accompanied by a sore throat that had developed just one day prior. Chest computed tomography (CT) disclosed pneumomediastinum alongside obstructive atelectasis in the left lower lobe. Streptococcus salivarius infection was conclusively identified through bronchoalveolar lavage metagenomic next-generation sequencing (mNGS), as well as smear and culture analyses. The patient was administered intravenous amoxicillin-clavulanate potassium for a duration of seven days as part of the anti-infection regimen. Given the stability of the patient's respiratory and circulatory systems, a tube drainage procedure was deemed unnecessary. Post-treatment, the patient's clinical symptoms notably improved. A subsequent chest CT scan revealed the re-expansion of the left lower lung and near-complete resolution of pneumomediastinum.

Conclusion: There are numerous pathogens that can cause pneumonia. While focusing on common pathogens, it is important not to overlook rare ones. When considering infections from rare pathogens, it is recommended to promptly perform a bronchoscopy and submit bronchoalveolar lavage fluid for mNGS to improve pathogen detection rates. During the diagnosis and treatment of pneumonia, it is crucial to be vigilant for rare complications. When a patient presents with symptoms such as dyspnea or subcutaneous emphysema, it is advisable to immediately perform a chest CT scan to rule out pneumomediastinum.

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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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