中国一例合并肝硬化的HIV阴性肺部感染病例报告及文献复习
HIV-Negative Case of Pulmonary Infection with Liver Cirrhosis in China: A Case Report and Literature Review.
作者信息
Liu Yu, Guo Hongying, Yuan Wei, Zou Ying, Qian Zhiping, Mei Xue, Ji Liujuan, Wang Jiefei, Zhang Yuyi
机构信息
Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.
出版信息
Infect Drug Resist. 2024 Apr 4;17:1333-1343. doi: 10.2147/IDR.S451880. eCollection 2024.
BACKGROUND
(TM) is the third most prevalent opportunistic infection in HIV-positive patients after tuberculosis and cryptococcosis. However, such infection of non-HIV individuals has rarely been reported.
CASE PRESENTATION
We describe a very rare case of a 52-year-old male who presented with a single space-occupying lesion on the right lung and was eventually diagnosed with pulmonary TM infection. The patient was HIV-negative and had liver cirrhosis with portal vein thrombosis. Lung tissue next-generation sequencing (NGS) revealed TM infection. We successfully treated the patient with voriconazole for 8 weeks and observed lesion absorption via subsequent CT. The patient consumed wild bamboo rats two months before admission. Mutations related to congenital immune deficiency were not detected by whole-exome sequencing.
CONCLUSION
Early and timely diagnosis is critical for improving patient prognosis. NGS plays a vital role in the diagnosis of pulmonary TM infection in patients. To our knowledge, this is the first published case of pulmonary TM infection in an HIV-negative patient with liver cirrhosis.
背景
（某种疾病，此处未明确写出全称，推测为隐球菌病）是艾滋病病毒阳性患者中仅次于结核病和隐球菌病的第三大常见机会性感染。然而，非艾滋病病毒感染者发生这种感染的情况鲜有报道。
病例报告
我们描述了一例非常罕见的病例，一名52岁男性，右肺出现单个占位性病变，最终被诊断为肺部（某种疾病）感染。该患者艾滋病病毒检测呈阴性，患有肝硬化伴门静脉血栓形成。肺组织下一代测序（NGS）显示存在（某种疾病）感染。我们用伏立康唑成功治疗该患者8周，并通过后续CT观察到病变吸收。患者在入院前两个月食用过竹鼠。全外显子测序未检测到与先天性免疫缺陷相关的突变。
结论
早期及时诊断对改善患者预后至关重要。NGS在患者肺部（某种疾病）感染的诊断中起着至关重要的作用。据我们所知，这是首例关于肝硬化的艾滋病病毒阴性患者发生肺部（某种疾病）感染的病例报道。
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