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先天性支气管闭锁并曲霉菌属烟曲霉引起的肺脓肿:一例报告。

Congenital bronchial atresia complicated by a lung abscess due to Aspergillus fumigatus: a case report.

机构信息

Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.

Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.

出版信息

BMC Pulm Med. 2021 Jan 6;21(1):2. doi: 10.1186/s12890-020-01367-5.

Abstract

BACKGROUND

Congenital bronchial atresia is a rare pulmonary abnormality characterized by the disrupted communication between the central and the peripheral bronchus and is typically asymptomatic. Although it can be symptomatic especially when infections occur in the involved areas, fungal infections are rare complications in patients with bronchial atresia. We report a case of congenital bronchial atresia complicated by a fungal infection.

CASE PRESENTATION

A 30-year-old man with no previous history of immune dysfunction was brought to a nearby hospital and diagnosed with a left lung abscess. Although antimicrobial treatment was administered, it was ineffective, and he was transferred to our hospital. Since diagnostic imaging findings and bronchoscopy suggested congenital bronchial atresia and a fungal infection, he was treated with voriconazole and surgical resection was subsequently performed. A tissue culture detected Aspergillus fumigatus and histopathological findings were compatible with bronchial atresia. After discharge, he remained well and voriconazole was discontinued 5 months after the initiation of therapy.

CONCLUSION

Bronchial atresia is a rare disease that is seldom complicated by a fungal infection, which is also a rare complication; however, physicians should consider fungal infections in patients with bronchial atresia who present with infections resistant to antimicrobial treatment.

摘要

背景

先天性支气管闭锁是一种罕见的肺部异常,其特征是中央和外周支气管之间的沟通中断,通常无症状。虽然它可能会出现症状,特别是在受累区域发生感染时,但真菌感染是支气管闭锁患者的罕见并发症。我们报告一例先天性支气管闭锁并发真菌感染的病例。

病例介绍

一名 30 岁男性,无免疫功能障碍病史,曾被送往附近医院诊断为左肺脓肿。尽管给予了抗菌治疗,但无效,他被转至我院。由于诊断影像学和支气管镜检查提示先天性支气管闭锁和真菌感染,他接受了伏立康唑治疗,随后进行了手术切除。组织培养检测到烟曲霉,组织病理学检查结果与支气管闭锁相符。出院后,他恢复良好,抗真菌治疗 5 个月后停用伏立康唑。

结论

支气管闭锁是一种罕见疾病,很少并发真菌感染,真菌感染也是一种罕见并发症;然而,对于支气管闭锁患者,出现对抗菌治疗无效的感染时,医生应考虑真菌感染的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9f/7788814/95be73418e94/12890_2020_1367_Fig1_HTML.jpg

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