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[首例空气露西菌引起的呼吸道感染病例报告]

[First case report of respiratory infection with Rothia aeria].

作者信息

Hiyamuta Hiroto, Tsuruta Nobuko, Matsuyama Tomomi, Satake Marie, Ohkusu Kiyofumi, Higuchi Kazuyuki

机构信息

Department of Respiratory Diseases, Hamanomachi Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2010 Mar;48(3):219-23.

Abstract

A 53-year-old woman was admitted to our hospital with dysbasia and forgetfulness. Her past history included uveitis at age 39. Medical examinations led to a diagnosis of neurosarcoidosis. Although she was treated with prednisolone, her symptoms remained, so she received steroid pulse therapy twice, and administration of azathioprine. In early January 2007, a chest X-ray film showed nodules in the right upper lung that rapidly increased in size and number. A CT scan revealed multiple nodules including cavitary lesions in both lung fields. Examination of bronchial lavage fluid and a transbronchial lung biopsy showed a mycelium-like gram-negative filament. After the treatment with benzylpenicillin for 1 month, her laboratory data and radiological abnormalities markedly ima proved. However, switching to oral administration of amoxicillin caused the regrowth of the nodules. She was retreated with intravenous benzylpenicillin for 8 weeks, followed by oral administration of amoxicillin for 5 months, and her condition completely resolved. The causative organism was identified as Rothia aeria (described in 2004) by 16S rRNA gene sequencing. This is the first report of a case of pulmonary infection with this species.

摘要

一名53岁女性因运动障碍和健忘入住我院。她的既往史包括39岁时患葡萄膜炎。医学检查诊断为神经结节病。尽管她接受了泼尼松龙治疗,但其症状仍未缓解,因此她接受了两次类固醇冲击治疗,并使用了硫唑嘌呤。2007年1月初,胸部X线片显示右上肺有结节,其大小和数量迅速增加。CT扫描显示双肺野有多个结节,包括空洞性病变。支气管灌洗和经支气管肺活检显示有菌丝样革兰氏阴性细丝。用苄星青霉素治疗1个月后,她的实验室数据和影像学异常明显改善。然而,改用阿莫西林口服后,结节再次出现。她再次接受静脉注射苄星青霉素治疗8周,随后口服阿莫西林5个月,病情完全缓解。通过16S rRNA基因测序,致病微生物被鉴定为空气露西氏菌(2004年描述)。这是该菌种引起肺部感染的首例报告。

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