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病例报告:六例肺炎患者的临床病例研究。

Case report: A clinical case study of six patients with pneumonia.

机构信息

Department of Respiratory Medicine, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.

Department of Respiratory Medicine, Jiashan County Yaozhuang Town Health Centre, Jiaxing, Zhejiang, China.

出版信息

Front Cell Infect Microbiol. 2023 Feb 24;13:1084882. doi: 10.3389/fcimb.2023.1084882. eCollection 2023.

Abstract

OBJECTIVE

To investigate the clinical features, diagnosis, and treatment of (i) pneumonia.

METHODS

We retrospectively analyzed the clinical data of six patients with pneumonia who were admitted to the Division of Pulmonary and Critical Care Medicine of the Second Hospital of Jiaxing from December 2021 to September 2022.

RESULTS

All patients reported a fever and other accompanying symptoms, including cough (5/6), chest tightness (1/6), fatigue (2/6), and headache (1/6). Laboratory results showed that all patients had high levels of C-reactive protein (CRP≥70 mg/L), procalcitonin (PCT; 2 patients with PCT levels ≥0.5 ng/L), and erythrocyte sedimentation rate (ESR). Lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) levels were elevated in 3/6 and of 2/6 patients, respectively. Chest computed tomography (CT) of most patients showed patchy, high-density shadows with partial consolidation, accompanied by air bronchogram signs and pleural effusion. Six patients were diagnosed with pneumonia using metagenomic next-generation sequencing (mNGS). They showed favorable outcomes following immediate adjustment of the regimen to doxycycline-based therapy and hydration, nutrition, and other follow-up treatments. In the imaging findings obtained at one-two month, the lesions were completely cleared, suggesting a favorable prognosis.

CONCLUSION

Patients with pneumonia commonly present sepsis and rapidly progressing disease. Early diagnosis is critical for pneumonia using mNGS, which can lead to favorable prognoses immediate adjustment therapies.

摘要

目的

探讨 肺炎的临床特征、诊断和治疗方法。

方法

我们回顾性分析了 2021 年 12 月至 2022 年 9 月嘉兴市第二医院呼吸与危重症医学科收治的 6 例 肺炎患者的临床资料。

结果

所有患者均有发热等伴随症状,包括咳嗽(5/6)、胸闷(1/6)、乏力(2/6)和头痛(1/6)。实验室结果显示,所有患者的 C 反应蛋白(CRP≥70mg/L)、降钙素原(PCT;2 例患者的 PCT 水平≥0.5ng/L)和红细胞沉降率(ESR)均升高。3/6 例患者的乳酸脱氢酶(LDH)和天门冬氨酸氨基转移酶(AST)水平升高,分别为 2/6 例。大多数患者的胸部计算机断层扫描(CT)显示斑片状高密度影,部分实变,伴有空气支气管征和胸腔积液。6 例患者通过宏基因组下一代测序(mNGS)诊断为 肺炎。他们在立即调整方案为多西环素为基础的治疗以及补液、营养等后续治疗后,结果良好。在一至两个月的影像学检查结果中,病变完全清除,提示预后良好。

结论

肺炎患者常伴有脓毒症和疾病快速进展。早期诊断对使用 mNGS 治疗 肺炎至关重要,这可以导致立即调整治疗方案,从而获得良好的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/311f/9999381/942b98b052c6/fcimb-13-1084882-g001.jpg

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