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[脑膜败血伊丽莎白金菌继发大疱性肺炎及其临床和影像学演变]

[Bullous pneumonia secondary to Elizabethkingia meningoseptica, its clinical and radiological evolution].

作者信息

Esteban Ignacio, Morales Cintia, Pinheiro Jose L, Galván María E, Isasmendi Adela, Castaños Claudio

机构信息

Servicio de Neumonología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.

Unidad de Cuidados Intensivos, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Arch Argent Pediatr. 2019 Apr 1;117(2):e150-e154. doi: 10.5546/aap.2019.e150.

Abstract

Elizabethkingia meningoseptica is an opportunistic pathogen with a high mortality and an increasing incidence in the intensive care units. We present a 4-year-old patient with a history of atresia of the biliary tract and a liver transplant at 11 months of age, who was admitted for acute respiratory infection with hypoxemia. During the hospitalization, she required mechanical ventilation. Due to persistent fever and hypoxemia, mini bronchoalveolar lavage was performed with a positive culture for Elizabethkingia meningoseptica. She received vancomycin, trimethoprim/sulfamethoxazole and ciprofloxacin for 14 days with a good response. A chest tomography showed the presence of mosaic hypoperfusion, cystic images, and bilateral bronchiectasis. During the following 2 years, she presented good clinical progress, with scarce respiratory infections, isolated symptoms and good tolerance to exercise. The resolution of the majority of the initial lesions was evidenced at 20 months of follow-up.

摘要

脑膜败血伊丽莎白金菌是一种机会致病菌,在重症监护病房中死亡率高且发病率不断上升。我们报告一名4岁患者,有胆道闭锁病史,11个月大时接受了肝移植,因急性呼吸道感染伴低氧血症入院。住院期间,她需要机械通气。由于持续发热和低氧血症,进行了微量支气管肺泡灌洗,培养结果显示脑膜败血伊丽莎白金菌呈阳性。她接受了万古霉素、甲氧苄啶/磺胺甲恶唑和环丙沙星治疗14天,反应良好。胸部断层扫描显示存在马赛克样灌注不足、囊性影像和双侧支气管扩张。在接下来的2年里,她临床进展良好,呼吸道感染很少,症状孤立,对运动耐受性良好。随访20个月时,大多数初始病变得到缓解。

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