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一名系统性红斑狼疮患者的肺炎:病例研究

Pneumonia in an SLE Patient: A Case Study.

作者信息

Li Xi, Zong Laibin, Zhu Yongze, Li Yali, Zhou Yonglie, Zhou Hua

机构信息

Centre of Laboratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, People's Republic of China.

Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, People's Republic of China.

出版信息

Infect Drug Resist. 2020 Aug 7;13:2745-2749. doi: 10.2147/IDR.S255968. eCollection 2020.

Abstract

The risk of opportunistic fungal infections is high in immunocompromised patients. The genus is common and diverse in nature. However, it rarely causes infection in humans. Here, we reported a case of pneumonia in a systemic lupus erythematosus (SLE) patient, and the morphological characteristics of were also described. The patient was a 64-year-old female. She had been diagnosed with SLE and membranous lupus nephritis 10 months previously. Her medications included methylprednisolone, cyclosporine, and hydroxychloroquine. She was admitted because of fever and diagnosed with pneumonia. was isolated from sputum and bronchoalveolar lavage (BAL) samples. BAL fluid stained with multiple stains showed the presence of somewhat dichotomously branching septate fungal hyphae. was identified, and its morphological features were described. Antibiotic susceptibility profiles showed that this strain had higher minimum inhibitory concentration (MIC) values in response to multiple antifungal drugs. The patient died 10 days after diagnosis. To the best of our knowledge, this report is the second to demonstrate that causes infection and is the first to present an infection (pneumonia) caused by i in an SLE patient. Clinical and laboratory personnel should be aware that the genus also contains pathogenic bacteria that cannot simply be treated as contaminants, especially in immunosuppressed patients.

摘要

免疫功能低下的患者发生机会性真菌感染的风险很高。该属在自然界中常见且多样。然而,它很少引起人类感染。在此,我们报告了一例系统性红斑狼疮(SLE)患者的肺炎病例,并描述了其形态特征。患者为一名64岁女性。她10个月前被诊断为SLE和膜性狼疮性肾炎。她的药物包括甲泼尼龙、环孢素和羟氯喹。她因发热入院并被诊断为肺炎。从痰液和支气管肺泡灌洗(BAL)样本中分离出该菌。用多种染色剂染色的BAL液显示存在有点二叉分支的分隔真菌菌丝。鉴定出该菌,并描述了其形态特征。抗生素敏感性分析表明,该菌株对多种抗真菌药物的最低抑菌浓度(MIC)值较高。患者在诊断后10天死亡。据我们所知,本报告是第二例证明该菌可引起感染的病例,也是首例报告该菌在SLE患者中引起感染(肺炎)的病例。临床和实验室人员应意识到该属还包含不能简单地视为污染物的病原菌,尤其是在免疫抑制患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a85/7423344/9e58dc433d0c/IDR-13-2745-g0001.jpg

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