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人博卡病毒1型与肺炎支原体合并感染所致假膜性喉气管支气管炎:一例报告

Pseudomembranous laryngotracheobronchitis due to coinfection with human bocavirus 1 and Mycoplasma pneumoniae: a case report.

作者信息

Wen Shun-Hang, Lin Li, Yu Gang, Xu Chang-Fu, Zhang Hai-Lin, Zheng Yang-Ming

机构信息

Department of Children's Respiratory Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.

出版信息

Transl Pediatr. 2021 Mar;10(3):673-678. doi: 10.21037/tp-20-278.

Abstract

Pseudomembranous laryngotracheobronchitis is rarely reported yet potentially life-threatening infectious cause of airway obstruction in children. The causative organisms of this condition are often considered to promote bacterial superinfection following viral infection. We report a case of pseudomembranous laryngotracheobronchitis in a patient caused by human bocavirus 1 and (). A 2-year-old child was admitted to our hospital presenting with cough, hoarseness, and labored breathing. Computed tomography of the chest revealed atelectasis of the right middle lobe of the lung with bronchostenosis and occlusion. Laryngeal edema, pseudomembrane formation and ulceration of the trachea were found during bronchoscopy. Chronic inflammation of the mucosa and local cellulose exudation with acute and chronic inflammatory cell infiltration were confirmed by hematoxylin-eosin staining. Human bocavirus 1 and were detected in the bronchoalveolar lavage fluid by next-generation sequencing. The patient tested positive for IgM antibodies against . Bronchoscopy was performed three times to clear the secretions in the airway, and azithromycin, ceftriaxone, methylprednisolone, budesonide inhalation, and ambroxol were administered as treatment. The patient's condition improved and she was discharged 21 days after admission. Clinicians should be aware of the potential involvement of human bocavirus 1 and in pseudomembranous laryngotracheobronchitis for accurate diagnosis and timely antibiotic administration, and to lower mortality and morbidity rates.

摘要

假膜性喉气管支气管炎虽罕见,但却是儿童气道梗阻潜在的危及生命的感染病因。这种病症的致病微生物通常被认为是在病毒感染后促使细菌发生二重感染。我们报告一例由人博卡病毒1型引起的假膜性喉气管支气管炎病例。一名2岁儿童因咳嗽、声音嘶哑和呼吸费力入院。胸部计算机断层扫描显示右肺中叶肺不张伴支气管狭窄和闭塞。支气管镜检查发现喉部水肿、假膜形成及气管溃疡。苏木精-伊红染色证实黏膜慢性炎症及局部纤维素渗出伴急性和慢性炎性细胞浸润。通过二代测序在支气管肺泡灌洗液中检测到人博卡病毒1型。该患者针对[具体病毒名称]的IgM抗体检测呈阳性。进行了三次支气管镜检查以清除气道分泌物,并给予阿奇霉素、头孢曲松、甲泼尼龙、布地奈德吸入及氨溴索进行治疗。患者病情好转,入院21天后出院。临床医生应意识到人博卡病毒1型在假膜性喉气管支气管炎中的潜在作用,以便准确诊断并及时给予抗生素治疗,从而降低死亡率和发病率。 (原文括号处信息缺失,无法准确翻译)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9333/8041609/e583821244bf/tp-10-03-673-f1.jpg

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