Guo Wenjia, Gao Bo, Li Li, Gai Wei, Yang Jianghui, Zhang Yan, Wang Lijun
Department of Pulmonary and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of China.
National Engineering Research Center for Beijing Biochip Technology, Beijing, People's Republic of China.
Infect Drug Resist. 2019 Aug 8;12:2467-2470. doi: 10.2147/IDR.S218921. eCollection 2019.
A lung abscess is an infectious pulmonary disease characterized by pus-filled cavity formation and often an air-fluid level. In this article, we described an indolent community-acquired lung abscess suspected as a tumor previously. A 56-year-old male presented with cough and expectoration for 2 months and hemoptysis for 2 weeks. His physical examinations, whole blood count and C-reactive protein level were normal. The chest computed tomography (CT) scan showed a 40×38×39 mm high-density mass in the right upper pulmonary lobe, with irregular borders. The pathology of a CT-guided percutaneous needle aspiration biopsy showed numerous inflammatory cells and bacteria infiltration without tumor lesions. Bacteriological detection of lung tissue revealed the cause was odontogenic flora. A next-generation sequencing demonstrated the etiologic correlation between lung abscess and periodontitis. After a 2-month pathogen-directed oral antibiotics therapy combined with chlorhexidine gargle oral care, this patient showed a remarkable improvement. Periodontitis can be a cause of a lung abscess, which would be taken into account in the treatment regimes preventing infectious recurrence.
肺脓肿是一种感染性肺部疾病，其特征为形成充满脓液的空洞，且常伴有气液平面。在本文中，我们描述了一例先前被怀疑为肿瘤的惰性社区获得性肺脓肿。一名56岁男性，咳嗽咳痰2个月，咯血2周。其体格检查、全血细胞计数及C反应蛋白水平均正常。胸部计算机断层扫描（CT）显示右上肺叶有一个40×38×39 mm的高密度肿块，边界不规则。CT引导下经皮针吸活检的病理结果显示有大量炎性细胞和细菌浸润，无肿瘤病变。肺组织细菌学检测显示病因是牙源性菌群。二代测序显示肺脓肿与牙周炎之间存在病因学关联。经过2个月的针对病原体的口服抗生素治疗并联合洗必泰含漱口腔护理，该患者病情显著改善。牙周炎可能是肺脓肿的一个病因，在预防感染复发的治疗方案中应予以考虑。
