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免疫功能正常患者因感染导致暴发性致命性肺炎和菌血症:病例报告及文献复习。

Fulminant fatal pneumonia and bacteremia due to in an immunocompetent man: a case report and literature review.

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Pulmonary and Critical Care Medicine, The People's Hospital of Dazu, Chongqing, China.

出版信息

Front Cell Infect Microbiol. 2024 Jul 15;14:1359422. doi: 10.3389/fcimb.2024.1359422. eCollection 2024.

Abstract

BACKGROUND

is associated with soft tissue infection, bacteremia and gastroenteritis. Involvement of respiratory system in adults is extremely rare. We report a case of fulminant pneumonia and bacteremia due to in a patient without underlying diseases.

CASE PRESENTATION

A 26-year-old man became ill suddenly with pneumonia after swimming in a river. Despite intensive support measures in the intensive care unit, he died 13 hours after admission and 4 days after his first symptoms. Autopsy showed abundant Gram-negative bacteria, massive inflammatory cell infiltration, edema, necrosis and hemorrhage in lung tissue. was isolated from blood culture taken at admission and bronchoalveolar lavage fluid (BALF) after intubation. Moreover, was also detected in lung tissue by metagenomic next-generation sequencing (mNGS) assay. The infection may have come from river water.

CONCLUSION

In patients who develop a fulminant pneumonia after contacting an aquatic environment, should be alerted and mNGS may aid in the detection of aquatic pathogens by being more sensitive and specific versus traditional bacterial culture.

摘要

背景

与软组织感染、菌血症和肠胃炎有关。成人呼吸系统受累极为罕见。我们报告了一例无潜在疾病的患者因感染而发生暴发性肺炎和菌血症。

病例介绍

一名 26 岁男子在河中游泳后突然患肺炎。尽管在重症监护病房进行了强化支持措施,他还是在入院后 13 小时死亡,并且在出现第一个症状后的第 4 天死亡。尸检显示肺部组织中存在大量革兰氏阴性菌、大量炎症细胞浸润、水肿、坏死和出血。在入院时采集的血培养和气管插管后的支气管肺泡灌洗液(BALF)中均分离到。此外,通过宏基因组下一代测序(mNGS)检测也在肺组织中检测到。感染可能来自河水。

结论

在接触水生环境后发生暴发性肺炎的患者中,应警惕,mNGS 可能比传统的细菌培养更敏感和特异,有助于检测水生病原体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be17/11284091/906c42b74ec1/fcimb-14-1359422-g001.jpg

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