Department of Neurology, West China Hospital of Sichuan University, Chengdu Sichuan 610041, PR China.
Pulmonary and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu Sichuan 610041, PR China; State Key Laboratory of Respiratory Health and Multimorbidity, Chengdu Sichuan 610041, PR China.
Diagn Microbiol Infect Dis. 2024 Sep;110(1):116347. doi: 10.1016/j.diagmicrobio.2024.116347. Epub 2024 May 10.
In this article we report a case of disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent patient with chronic obstructive pulmonary disease (COPD) who complained of a cough, followed by skin and intracranial lesions. On metagenomic next-generation sequencing (mNGS) technology of respiratory samples (bronchoalveolar lavage fluid, BALF) Nocardia otitidiscaviarum was identified. The patient was treated with therapy combined with a low dose of TMP-SMX and imipenem cilastatin sodium and had a favorable outcome. The timely diagnosis of Nocardia with the help of mNGS technology and early rational treatment of TMP-SMX can help improve the prognosis.
本文报道了一例免疫功能正常的慢性阻塞性肺疾病(COPD)患者罹患由鼻疽奴卡菌引起的播散性奴卡菌病的病例,该患者以咳嗽起病,继而出现皮肤和颅内病变。通过对呼吸道样本(支气管肺泡灌洗液,BALF)进行宏基因组下一代测序(mNGS)技术检测,鉴定出鼻疽奴卡菌。该患者采用包含低剂量复方磺胺甲噁唑和亚胺培南西司他丁钠的联合治疗方案,取得了良好的治疗效果。mNGS 技术有助于及时诊断奴卡菌病,早期合理应用复方磺胺甲噁唑治疗,有助于改善预后。