Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA.
BMJ Case Rep. 2023 Jun 20;16(6):e250107. doi: 10.1136/bcr-2022-250107.
, a common coloniser of the urogenital tract, is a rare cause of respiratory infections in an immunocompetent patient. lacks a cell wall and can be difficult to identify with standard culture methods posing difficulties in diagnosis and treatment. We describe a case of pneumonia in an immunocompetent man in his early 40s without any risk factors presenting with a cavitary lesion who developed empyema and necrotising pneumonia requiring surgical debridement. Identification of and subsequent modification of antibiotic therapy led to favourable outcome. should be considered in the differential diagnosis of patients with treatment resistant pneumonia especially in patients with trauma, intracranial injury, lung transplant or if immunocompromised. While is naturally resistant to all antibiotics that target cell wall synthesis, we recommend levofloxacin or other fluoroquinolone to most effectively treat with doxycycline as a potential alternative.
淋病奈瑟菌是一种常见的泌尿生殖道定植菌，很少引起免疫功能正常患者的呼吸道感染。淋病奈瑟菌缺乏细胞壁，用标准培养方法难以识别，这给诊断和治疗带来了困难。我们描述了一例 40 多岁免疫功能正常的男性患者无任何危险因素，表现为空洞性病变，发生脓胸和坏死性肺炎，需要手术清创。鉴定出淋病奈瑟菌并随后修改抗生素治疗方案，导致了有利的结果。对于治疗抵抗性肺炎的患者，应考虑淋病奈瑟菌作为鉴别诊断，特别是对于有创伤、颅内损伤、肺移植或免疫功能低下的患者。虽然淋病奈瑟菌天然对抗所有针对细胞壁合成的抗生素，但我们建议使用左氧氟沙星或其他氟喹诺酮类药物进行治疗，多西环素是一种潜在的替代药物。
