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胸腺瘤手术后多次术后肺部感染被诊断为非结核分枝杆菌感染。

Multiple Postoperative Lung Infections after Thymoma Surgery Diagnosed as Nontuberculous Mycobacterial Infection.

出版信息

Clin Lab. 2024 Aug 1;70(8). doi: 10.7754/Clin.Lab.2024.240315.

Abstract

BACKGROUND

Thymomas are thymic epithelial-derived, most common primary anterior mediastinal masses. Non-tuberculous mycobacteria (NTM) are species that do not cause leprosy and belong to species outside the Mycobacterium tuberculosis complex.

METHODS

With the clinical application of targeted next-generation sequencing (tNGS), we promptly confirmed a case of NTM infection combined with NTM infection after thymoma surgery, and we performed a joint literature analysis of the two diseases to improve clinicians' understanding and recognition of lung infections after thymoma surgery.

RESULTS

Chest CT of both lungs showed multiple hyperdense shadows. Sputum bacterial culture and characterization detected Neisseria Dryad and Streptococcus Grass Green. The presence of Mycobacterium abscessus infection was confirmed by alveolar lavage fluid sent for second-generation macro gene sequencing.

CONCLUSIONS

The body's immune function decreases after thymoma surgery. When empirical anti-infection treatment for recurrent pneumonia in the lungs is ineffective, we should be alerted to the possibility of the presence of pulmonary non-tuberculous mycobacterial infection, and next-generation sequencing should be performed promptly to arrive quickly at a diagnosis.

摘要

背景

胸腺瘤是由胸腺上皮细胞衍生而来的,是最常见的原发性前纵隔肿块。非结核分枝杆菌(NTM)是指不会引起麻风病的菌种,属于结核分枝杆菌复合群以外的菌种。

方法

随着靶向二代测序(tNGS)的临床应用,我们迅速确诊了一例胸腺瘤手术后合并 NTM 感染的病例,并对这两种疾病进行了联合文献分析,以提高临床医生对胸腺瘤手术后肺部感染的认识和认识。

结果

双肺 CT 显示多个高密度影。痰细菌培养和鉴定检测到 Neisseria Dryad 和 Streptococcus Grass Green。通过对送检的第二代宏基因测序肺泡灌洗液,证实存在脓肿分枝杆菌感染。

结论

胸腺瘤手术后机体免疫功能下降。当肺部复发性肺炎的经验性抗感染治疗无效时,应警惕存在肺部非结核分枝杆菌感染的可能,应及时进行二代测序以快速明确诊断。

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