Zhou Bingyan, Cheng Yibing, Wang Haijun, Lin Li, Zheng Huiwen, Shen Yuelin
Emergency Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, 450018, China.
Laboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, 100045, China.
Heliyon. 2024 Jul 14;10(14):e34536. doi: 10.1016/j.heliyon.2024.e34536. eCollection 2024 Jul 30.
() infection is rare in children who were previously healthy, particularly in infants. We present the first report of a family outbreak of infection among immunocompetent infant triplets.
We reviewed triplets' demographic data, laboratory tests and imaging examinations to describe their clinical features. We performed whole-exome sequencing to rule out primary immunodeficiency disorders. We used DNA sequencing for subspecies identification.
The fraternal triplets (triples A, B and C) presented with a 10-day history of cough. Triple A also experienced a brief episode of fever, and triple B had tachypnea. Chest CT scans showed pulmonary masses and nodules in triples A and C, and cavities in triple B. Cultures of sputum and bronchoalveolar lavage fluid from all triplets yielded . Further subspecies identification showed that isolates from triples A and C were subsp. , and isolates from triple B were subsp. (MAA). After eight months of combination therapy, the pulmonary lesions of the triplets improved significantly.
Our study confirms that pulmonary disease can occur in immunocompetent infants. We hypothesize that the simultaneous infection of the triplets may be associated with their prematurity and extensive environmental exposure. This study highlights the importance to include infection in the differential diagnosis of pulmonary masses and/or cavities, regardless of the age of onset or the presence of underlying pathology or susceptible genes.
（）感染在既往健康的儿童中较为罕见，尤其是在婴儿中。我们报告了首例免疫功能正常的三胞胎婴儿家庭爆发（）感染的病例。
我们回顾了三胞胎的人口统计学数据、实验室检查和影像学检查，以描述其临床特征。我们进行了全外显子组测序，以排除原发性免疫缺陷疾病。我们使用DNA测序进行（）亚种鉴定。
异卵三胞胎（A、B和C）有10天的咳嗽病史。A还经历了短暂的发热，B有呼吸急促。胸部CT扫描显示A和C有肺部肿块和结节，B有空洞。所有三胞胎的痰液和支气管肺泡灌洗液培养均检出（）。进一步的亚种鉴定显示，A和C的分离株为（）亚种，B的分离株为（）亚种（MAA）。经过八个月的联合治疗，三胞胎的肺部病变明显改善。
我们的研究证实，免疫功能正常的婴儿也可发生（）肺部疾病。我们推测三胞胎同时感染可能与其早产和广泛的环境暴露有关。本研究强调，无论发病年龄、是否存在潜在病理或易感基因，在肺部肿块和/或空洞的鉴别诊断中都应考虑（）感染。
