多重厌氧感染所致重症肺炎合并脓胸：病例报告及文献综述
Severe pneumonia with empyema due to multiple anaerobic infections: case report and literature review.
作者信息
Yu Fangyu, Zhang Xiaojing, Li Yujiao, Gai Wei, Zheng Yafeng, Cai Xudong
机构信息
Department of ICU, Ningbo Municipal Hospital of Traditional Chinese Medicine (TCM), Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China.
WillingMed Technology (Beijing) Co., Ltd, Beijing, China.
出版信息
Front Med (Lausanne). 2024 Aug 14;11:1435823. doi: 10.3389/fmed.2024.1435823. eCollection 2024.
BACKGROUND
Cases of severe pneumonia complicated by empyema due to normal anaerobic flora from the oral cavity are infrequent. Diagnosing anaerobic infections through conventional microbiological test (CMT) is often challenging.
CASE PRESENTATION
This study describes the case of a 67-year-old man, bedridden long-term, who developed severe pneumonia with empyema caused by multiple anaerobic bacterial infections. The patient was hospitalized with a 5-day history of cough, sputum and fever, accompanied by a 2-day history of dyspnea. Despite CMT, the specific etiology remained elusive. However, metagenomic next-generation sequencing (mNGS) identified various anaerobic bacteria in bronchoalveolar lavage fluid (BALF), blood and pleural effusion. The patient was diagnosed with a polymicrobial infection involving multiple anaerobic bacteria. Following treatment with metronidazole and moxifloxacin, the patient's pulmonary symptoms improved.
CONCLUSION
mNGS serves as a valuable adjunctive tool for diagnosting and managing patients whose etiology remains unidentified following CMT.
背景
由口腔正常厌氧菌群引起的重症肺炎合并脓胸的病例并不常见。通过传统微生物检测（CMT）诊断厌氧感染往往具有挑战性。
病例报告
本研究描述了一名长期卧床的67岁男性患者，因多种厌氧细菌感染导致重症肺炎伴脓胸。患者因咳嗽、咳痰和发热5天，伴有呼吸困难2天入院。尽管进行了CMT，但具体病因仍不明确。然而，宏基因组下一代测序（mNGS）在支气管肺泡灌洗液（BALF）、血液和胸腔积液中鉴定出多种厌氧细菌。该患者被诊断为涉及多种厌氧细菌的混合感染。在接受甲硝唑和莫西沙星治疗后，患者的肺部症状有所改善。
结论
对于经CMT后病因仍未明确的患者，mNGS是一种有价值的辅助诊断和管理工具。
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