肺部豚鼠耳炎諾卡菌感染一例并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

余方穎 , 胡權鋮 , 劉璐璐 , 方圳鴻 ,  周亮 ,  黃波

遵義醫科大學附屬醫院呼吸與危重癥醫學科（貴州遵義 563003）;

Corresponding?author：

周亮, Email: zhouliang1115@163.com; 黃波, Email: 13985229382@139.com

Keywords：

肺豚鼠耳炎諾卡菌; 重癥肺炎; 臨床特征; 治療; 預后

DOI：

10.7507/1671-6205.202112014

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的總結肺豚鼠耳炎諾卡菌病的臨床特點，以提高診斷和治療水平。方法回顧性分析1例肺豚鼠耳炎諾卡菌病的發病過程、臨床表現、胸部影像學和病原學檢查及診治過程。在PubMed數據庫以“pulmonary”和“Nocardia otitidiscaviarum”為檢索詞進行檢索，以“肺豚鼠耳炎諾卡菌”為檢索詞在中國知網、萬方數據庫中檢索年2016—2021年豚鼠耳炎諾卡菌病病例，并復習相關文獻。結果患者女，44歲，因“咳嗽、咳痰及痰中帶血伴發熱1 d”于2020年7月25日就診。入院診斷為重癥肺炎，既往有支氣管擴張病史，影像學檢查顯示肺部斑片狀陰影并空洞，通過痰涂片、痰培養及肺泡灌洗液病原學檢查結果提示肺豚鼠耳炎諾卡菌。感染急性期予美羅培南聯合去甲萬古霉素治療，后于院外口服復方磺胺甲噁唑治療3個月，隨訪1年未復發。結論肺部豚鼠耳炎諾卡菌病臨床少見，其臨床及影像學等表現無特異性，確診需依靠病原學檢查，首選磺胺類藥物治療。早診斷、早治療有助于改善肺豚部鼠耳炎諾菌病患者的預后。

Citation： 余方穎, 胡權鋮, 劉璐璐, 方圳鴻, 周亮, 黃波. 肺部豚鼠耳炎諾卡菌感染一例并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(3): 200-204. doi: 10.7507/1671-6205.202112014 Copy

1.	楊柳, 馬迎民. 肺豚鼠耳炎諾卡菌病1例. 中華老年多器官疾病雜志, 2016, 15(9): 697-699.
2.	姜波. 一例由豚鼠耳炎諾卡菌引起的肺諾卡菌病. 醫學檢驗與臨床, 2018, 29(9): 2.
3.	劉利華, 李釗, 李曉哲, 等. 豚鼠耳炎諾卡菌合并曲霉感染一例. 中國呼吸與危重監護雜志, 2019, 18(2): 179-181.
4.	沈軼, 張海, 李鋒, 等. 豚鼠耳炎諾卡菌肺病一例并文獻復習. 國際呼吸雜志, 2020, 40(12): 897-903.
5.	韓天強, 李繼東, 陳偉. 播散性肺豚鼠耳炎諾卡菌病1例并文獻復習. 臨床肺科雜志, 2019, 24(10): 198-200.
6.	董毅娟, 王宇翔. 肺泡灌洗液檢出到豚鼠耳炎諾卡菌一例分析報告. 飲食保健, 2020, 7(11): 98-99.
7.	王更芳, 周曉莉, 顧文賢, 等. 肺諾卡菌病一例. 中華病理學雜志, 2019, 48(9): 726-727.
8.	魏孔芳, 賈金虎. 豚鼠耳炎諾卡菌多部位感染致死1例報告. 中國臨床醫學, 2020, 27(3): 531-533.
9.	周磊, 李海峰, 李略. 肺豚鼠耳炎諾卡菌病一例報告. 現代實用醫學, 2020, 32(10): 1292-1293,1304.
10.	Liu C, Feng M, Zhu J, et al. Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer: a case report and literature review. Medicine, 2017, 96(13): e6526.
11.	Saksena R, Rynga D, Rajan S, et al. Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review. J Infect Dev Ctries, 2020, 14(2): 214-222.
12.	Mahgoub A. Pulmonary nocardiosis caused by Nocardia otitidiscaviarum in an adult asthmatic female patient: the presence of acid-fast branching filaments is always significant. S Afr Med J, 2016, 107(1): 43.
13.	Deepa R, Banu ST, Jayalakshmi G, et al. Pleuropulmonary nocardiosis due to Nocardia otitidiscaviarum in a debilitated host. Indian J Pathol Microbiol, 2016, 59(2): 240-242.
14.	李鳳玉, 鄧靜敏. 肺諾卡菌病診治的研究進展. 中華臨床醫師雜志(電子版), 2020, 14(10): 848-852.
15.	Garcia BL, Sibila O, Solanes I, et al. Pulmonary nocardiosis in patients with COPD: characteristics and prognostic factors. Archivos De Bronconeumología, 2012, 48(8): 280-285.
16.	Chacón CF, Vicente R, Ramos F, et al. Nocardia farcinica lung infection in a patient with cystic fibrosis and a lung transplant. Rev Esp Anestesiol Reanim, 2015, 62(3): 161-164.
17.	何靖霓, 李園園, 蘇曉麗, 等. 肺皮疽奴卡菌重癥肺炎1例并25例病例文獻復習. 中國感染控制雜志, 2017, 16(2): 146-150,155.
18.	程振娜, 李剛, 師志云, 等. 諾卡菌感染的臨床特點分析. 寧夏醫科大學學報, 2017, 39(5): 537-540.
19.	宋秀杰, 路聰哲, 顧玨, 等. 84例肺奴卡菌病文獻回顧性分析1979-2011. 臨床肺科雜志, 2013, 18(12): 2280-2282.
20.	Usiakimi I, Sittana ES, Latif A. First human infection of Nocardia crassostreae in an immunocompetent patient. Chin Med J (Engl), 2016, 129(1): 114-115.
21.	Huang T, Chen Y, Zhang J, et al. Rapid and accurate diagnosis of brain abscess caused by Nocardia asiatica in combination of Ziehl-Neelsen stain and metagenomics next generation sequencing. Eur J Neurol, 2021, 28(1): 355-357.
22.	Kandi V. Human nocardia infections: a review of pulmonary nocardiosis. Cureus, 2015, 7(8): e304.
23.	Blackmon KN, Ravenel JG, Gomez JM, et al. Pulmonary nocardiosis: computed tomography features at diagnosis. J Thorac Imaging, 2011, 26(3): 224-229.
24.	Mehrian P, Esfandiari E, Karimi MA, et al. Computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients. Pol J Radiol, 2015, 80(2): 13.
25.	Coussement J, Lebeaux D, van Delden C, et al. Nocardia infection in solid organ transplant recipients: a multicenter European case-control study. Clin Infect Dis, 2016, 63(3): 338-345.
26.	Steinbrink J, Leavens J, Kauffman CA, et al. Manifestations and outcomes of nocardia infections: comparison of immunocompromised and nonimmunocompromised adult patients. Medicine (Baltimore), 2018, 97(40): e12436.
27.	Lederman ER, Crum NF. A case series and focused review of nocardiosis: clinical and microbiologic aspects. Medicine (Baltimore), 2004, 83(5): 300-313.
28.	朱詩應, 戚中田. 16 S rDNA擴增及測序在細菌鑒定與分類中的應用. 微生物與感染, 2013, 8(2): 104-109.
29.	Tremblay J, Thibert L, Alarie I, et al. Nocardiosis in Quebec, Canada, 1988-2008. Clin Microbiol Infect, 2011, 17(5): 690-696.
30.	Wilson JW. Nocardiosis: updates and clinical overview. Mayo Clin Proc, 2012, 87(4): 403-407.
31.	柳靜文, 呂瑋. 播散性奴卡菌病21例臨床特征分析. 中國臨床醫生雜志, 2019, 47(5): 539-541.
32.	Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev, 2006, 19(2): 259-282.
33.	周佳, 金博, 黃磊, 等. 諾卡菌感染的菌種和藥敏試驗回顧性分析. 重慶醫學, 2018, 47(19): 4.
34.	高春明, 翟惠, 李峰, 等. 38例諾卡菌感染臨床特征與藥敏分析. 中國醫院藥學雜志, 2012, 32(5): 2.
35.	Saubolle MA, Sussland D. Nocardiosis: review of clinical and laboratory experience. J Clin Microbiol, 2003, 41(10): 4497-501.
36.	中華醫學會呼吸病學分會. 中國成人社區獲得性肺炎診斷和治療指南(2016年版). 中華結核和呼吸雜志, 2016, 39(4): 253-279.

1. 楊柳, 馬迎民. 肺豚鼠耳炎諾卡菌病1例. 中華老年多器官疾病雜志, 2016, 15(9): 697-699.
2. 姜波. 一例由豚鼠耳炎諾卡菌引起的肺諾卡菌病. 醫學檢驗與臨床, 2018, 29(9): 2.
3. 劉利華, 李釗, 李曉哲, 等. 豚鼠耳炎諾卡菌合并曲霉感染一例. 中國呼吸與危重監護雜志, 2019, 18(2): 179-181.
4. 沈軼, 張海, 李鋒, 等. 豚鼠耳炎諾卡菌肺病一例并文獻復習. 國際呼吸雜志, 2020, 40(12): 897-903.
5. 韓天強, 李繼東, 陳偉. 播散性肺豚鼠耳炎諾卡菌病1例并文獻復習. 臨床肺科雜志, 2019, 24(10): 198-200.
6. 董毅娟, 王宇翔. 肺泡灌洗液檢出到豚鼠耳炎諾卡菌一例分析報告. 飲食保健, 2020, 7(11): 98-99.
7. 王更芳, 周曉莉, 顧文賢, 等. 肺諾卡菌病一例. 中華病理學雜志, 2019, 48(9): 726-727.
8. 魏孔芳, 賈金虎. 豚鼠耳炎諾卡菌多部位感染致死1例報告. 中國臨床醫學, 2020, 27(3): 531-533.
9. 周磊, 李海峰, 李略. 肺豚鼠耳炎諾卡菌病一例報告. 現代實用醫學, 2020, 32(10): 1292-1293,1304.
10. Liu C, Feng M, Zhu J, et al. Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer: a case report and literature review. Medicine, 2017, 96(13): e6526.
11. Saksena R, Rynga D, Rajan S, et al. Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review. J Infect Dev Ctries, 2020, 14(2): 214-222.
12. Mahgoub A. Pulmonary nocardiosis caused by Nocardia otitidiscaviarum in an adult asthmatic female patient: the presence of acid-fast branching filaments is always significant. S Afr Med J, 2016, 107(1): 43.
13. Deepa R, Banu ST, Jayalakshmi G, et al. Pleuropulmonary nocardiosis due to Nocardia otitidiscaviarum in a debilitated host. Indian J Pathol Microbiol, 2016, 59(2): 240-242.
14. 李鳳玉, 鄧靜敏. 肺諾卡菌病診治的研究進展. 中華臨床醫師雜志(電子版), 2020, 14(10): 848-852.
15. Garcia BL, Sibila O, Solanes I, et al. Pulmonary nocardiosis in patients with COPD: characteristics and prognostic factors. Archivos De Bronconeumología, 2012, 48(8): 280-285.
16. Chacón CF, Vicente R, Ramos F, et al. Nocardia farcinica lung infection in a patient with cystic fibrosis and a lung transplant. Rev Esp Anestesiol Reanim, 2015, 62(3): 161-164.
17. 何靖霓, 李園園, 蘇曉麗, 等. 肺皮疽奴卡菌重癥肺炎1例并25例病例文獻復習. 中國感染控制雜志, 2017, 16(2): 146-150,155.
18. 程振娜, 李剛, 師志云, 等. 諾卡菌感染的臨床特點分析. 寧夏醫科大學學報, 2017, 39(5): 537-540.
19. 宋秀杰, 路聰哲, 顧玨, 等. 84例肺奴卡菌病文獻回顧性分析1979-2011. 臨床肺科雜志, 2013, 18(12): 2280-2282.
20. Usiakimi I, Sittana ES, Latif A. First human infection of Nocardia crassostreae in an immunocompetent patient. Chin Med J (Engl), 2016, 129(1): 114-115.
21. Huang T, Chen Y, Zhang J, et al. Rapid and accurate diagnosis of brain abscess caused by Nocardia asiatica in combination of Ziehl-Neelsen stain and metagenomics next generation sequencing. Eur J Neurol, 2021, 28(1): 355-357.
22. Kandi V. Human nocardia infections: a review of pulmonary nocardiosis. Cureus, 2015, 7(8): e304.
23. Blackmon KN, Ravenel JG, Gomez JM, et al. Pulmonary nocardiosis: computed tomography features at diagnosis. J Thorac Imaging, 2011, 26(3): 224-229.
24. Mehrian P, Esfandiari E, Karimi MA, et al. Computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients. Pol J Radiol, 2015, 80(2): 13.
25. Coussement J, Lebeaux D, van Delden C, et al. Nocardia infection in solid organ transplant recipients: a multicenter European case-control study. Clin Infect Dis, 2016, 63(3): 338-345.
26. Steinbrink J, Leavens J, Kauffman CA, et al. Manifestations and outcomes of nocardia infections: comparison of immunocompromised and nonimmunocompromised adult patients. Medicine (Baltimore), 2018, 97(40): e12436.
27. Lederman ER, Crum NF. A case series and focused review of nocardiosis: clinical and microbiologic aspects. Medicine (Baltimore), 2004, 83(5): 300-313.
28. 朱詩應, 戚中田. 16 S rDNA擴增及測序在細菌鑒定與分類中的應用. 微生物與感染, 2013, 8(2): 104-109.
29. Tremblay J, Thibert L, Alarie I, et al. Nocardiosis in Quebec, Canada, 1988-2008. Clin Microbiol Infect, 2011, 17(5): 690-696.
30. Wilson JW. Nocardiosis: updates and clinical overview. Mayo Clin Proc, 2012, 87(4): 403-407.
31. 柳靜文, 呂瑋. 播散性奴卡菌病21例臨床特征分析. 中國臨床醫生雜志, 2019, 47(5): 539-541.
32. Brown-Elliott BA, Brown JM, Conville PS, et al. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev, 2006, 19(2): 259-282.
33. 周佳, 金博, 黃磊, 等. 諾卡菌感染的菌種和藥敏試驗回顧性分析. 重慶醫學, 2018, 47(19): 4.
34. 高春明, 翟惠, 李峰, 等. 38例諾卡菌感染臨床特征與藥敏分析. 中國醫院藥學雜志, 2012, 32(5): 2.
35. Saubolle MA, Sussland D. Nocardiosis: review of clinical and laboratory experience. J Clin Microbiol, 2003, 41(10): 4497-501.
36. 中華醫學會呼吸病學分會. 中國成人社區獲得性肺炎診斷和治療指南(2016年版). 中華結核和呼吸雜志, 2016, 39(4): 253-279.

Previous Article
Anti-tumor effect of superantigen staphylococcal enterotoxin B gene for mice beared by Lewis lung cancer cell
Next Article
原發性纖毛不動綜合征一例

Chinese Journal of Respiratory and Critical Care Medicine

肺部豚鼠耳炎諾卡菌感染一例并文獻復習

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content