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find Keyword "诺卡菌病" 2 results
  • Pulmonary nocardiosis associated with bronchiectasis: report of two cases and literature review

    ObjectiveTo describe the clinical characteristics of pulmonary nocardiosis associated with bronchiectasis and to evaluate the methods of diagnosis and treatment.MethodsClinical data of two patients with pulmonary nocardiosis and bronchiectasis were analyzed and the literature on the subject were reviewed.ResultsTwo female patients with bronchiectasis were respectively 55 and 62 years old, both of them presented with fever, cough, expectoration, and leukocytosis. Case 1 also complicated with respiratory failure and leukemoid reaction. Chest CT showed bilateral pulmonary multi-patchy consolidations with cavities in case 1 and unilateral pulmonary local consolidation without cavities in case 2. Sputum smears on modified Ziehl-Neelsen staining of both patients showed typical Nocardia hyphe. Sputum culture of case 1 showed Nocardia otitidiscaviarum, which was sensitive to sulfamethoxazole/trimethoprim (SMZ/TMP), amikacin and moxifloxacin while resistant to ceftriaxone, imipenem and meropenem. Sputum culture of case 2 was negative. Case 1 was treated with SMZ/TMP + moxifloxacin + amikacin for 6 months, and case 2 treated with SMZ/TMP for 3 months. Both patients were clinically cured. Six case reports including 7 patients were searched, including 4 Chinese reports and 2 English reports. Most of them were reported individually. ConclusionsBronchiectasis is a risk factor for pulmonary nocardiosis, and the treatment of nocardiosis should accord with drug susceptibilities and severities of diseases. The prognoses of patients with pulmonary nocardiosis and bronchiectasis are relatively good.

    Release date:2019-03-22 04:20 Export PDF Favorites Scan
  • 新型冠状病毒感染继发诺卡菌病合并活动性肺结核一例并文献复习

    目的 分析新型冠状病毒感染继发诺卡菌病合并活动性肺结核患者的临床特征,提高临床医师对诺卡菌病的认识。方法 回顾性分析1例新型冠状病毒感染患者继发诺卡菌病合并活动性肺结核病例的临床症状、实验室检查、影像学检查、病原学结果及治疗,并复习国内外相关文献。结果 患者女,72岁,在新型冠状病毒感染后出现长期反复发热、咳嗽和咳痰,胸部CT提示双肺炎症,痰涂片抗酸染色阴性,常规痰培养未见可疑致病菌,最终通过肺泡灌洗液宏基因组学二代基因测序发现圣乔治教堂诺卡菌合并结核分枝杆菌感染,经针对上述病原体抗感染治疗后患者病情显著缓解。文献复习显示诺卡菌感染在免疫缺陷患者中的风险高,其合并结核分枝杆菌感染时易出现漏诊和误诊。目前在新型冠状病毒感染期间或感染后出现的诺卡菌病例仅有少数报道,尚未检索到类似本例新型冠状病毒感染后继发诺卡菌病合并活动性肺结核的病例报告。结论 诺卡菌病的临床症状、体征和影像学缺乏特异性,病原学培养耗时长,因此对于新型冠状病毒感染后出现反复发热患者,应注重基于分子生物学的病原微生物检测,考虑是否存在诺卡菌合并结核分枝杆菌感染可能,避免因漏诊、误诊而延误治疗。

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