Wen W, Gu L, Zhao L W, Chen M Y, Yang W Q, Liu W, Zhou X, Lai G X
Department of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, the 900th Hospital of the Joint Logistic Support Force, PLA, Fuzhou 350025, China.
The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2021 Jun 12;44(6):531-536. doi: 10.3760/cma.j.cn112147-20210205-00097.
In order to improve the understanding and clinical treatment of pneumonia, we analyzed the clinical manifestations, laboratory test results and imaging features of 8 patients. We collected the clinical data of 8 patients with pneumonia diagnosed by metagenomic next-generation-sequencing (mNGS) from November 2018 to February 2020, including clinical features, chest CT scan, pathological features and antibiotic use. A total of one male and 7 females, aged from 45 to 85 years(median 62 years), were included in this study. All the patients had high fever, cough and most had expectoration (6/8). The leukocyte count and PCT level were mostly normal (7/8). However, we observed decreased lymphocyte count(5/8), elevated C-reactive protein in all patients, and increased ESR in most patients (7/8). The chest CT of all the patients showed large patchy consolidation, with one case having pleural effusion. The pathological manifestations were nonspecific, showing infiltration of inflammatory cells and exudation. Moxifloxacin and/or doxycycline were administered after diagnosis, and the course of treatment lasted from 14 to 21 days.Chest CT showed absorption of lesions following treatment pneumonia showed certain characteristics, including high fever with pulmonary patchy consolidation, and normal white blood cell count. Molecular diagnostic methods such as mNGS could lead to rapid diagnosis and treatment which can shorten the course of hospitalization and thus improve prognosis.
为提高对肺炎的认识和临床治疗水平,我们分析了8例患者的临床表现、实验室检查结果及影像学特征。我们收集了2018年11月至2020年2月间经宏基因组下一代测序(mNGS)确诊的8例肺炎患者的临床资料,包括临床特征、胸部CT扫描、病理特征及抗生素使用情况。本研究共纳入1例男性和7例女性,年龄45至85岁(中位年龄62岁)。所有患者均有高热、咳嗽,多数患者有咳痰(6/8)。白细胞计数和降钙素原水平大多正常(7/8)。然而,我们观察到淋巴细胞计数下降(5/8),所有患者C反应蛋白升高,多数患者血沉升高(7/8)。所有患者的胸部CT均显示大片状实变,1例有胸腔积液。病理表现无特异性,可见炎性细胞浸润和渗出。诊断后给予莫西沙星和/或多西环素治疗,疗程为14至21天。胸部CT显示治疗后病变吸收。肺炎表现出一定特征,包括高热伴肺部片状实变,白细胞计数正常。mNGS等分子诊断方法可实现快速诊断和治疗,从而缩短住院时间,改善预后。