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甲型流感(H1N1)合并金黄色葡萄球菌感染继发坏死性肺炎:一例报告

Necrotizing pneumonia secondary to Influenza A (H1N1) coinfection with Staphylococcus aureus: A case report.

作者信息

Chen Huibin, Duan Hui, Zhao Jinling, Sun Kang, Shan Keji

机构信息

Department of Intensive Medicine, the First Affiliated Hospital of Kunming Medical University, Kumming 650032, Yunnan, China.

出版信息

IDCases. 2024 Aug 22;37:e02066. doi: 10.1016/j.idcr.2024.e02066. eCollection 2024.

Abstract

OBJECTIVE

This study aims to enhance understanding of necrotizing pneumonia and toxic shock syndrome by analyzing an adult case of community-acquired necrotizing pneumonia caused by co-infection of Influenza A (H1N1) and Staphylococcus aureus with LukS-PV and LukF-PV virulence factor genes.

METHOD

The clinical data of one patient admitted to the intensive care unit (ICU) with co-infection of Influenza A (H1N1) and Staphylococcus aureus was retrospectively analyzed.

RESULTS

The patient exhibited typical clinical manifestations of viral and Staphylococcus aureus co-infection, including necrotizing pneumonia and toxic shock syndrome. The presence of LukS-PV and LukF-PV virulence factor genes of Staphylococcus aureus was detected in the patient's bronchoalveolar lavage fluid. Unfortunately,although antiviral agents (oseltamivir) and antibiotics (linezolid, imipenem-cilastatin) were timely administrated, as well as corticosteroids for anti-inflammatory purposes, the patient's condition was progressively deteriorated and eventually led to death.

CONCLUSION

Clinical practitioners should be vigilant about the co-infection of Influenza virus and Staphylococcus aureus, particularly when the latter carries virulence factors. The presence of virulence factor genes of Staphylococcus aureus can lead to necrotizing pneumonia with a poor prognosis. This is a particular concern because both infections can be life threatening in young adults.

摘要

目的

本研究旨在通过分析一例由甲型流感病毒(H1N1)与携带LukS - PV和LukF - PV毒力因子基因的金黄色葡萄球菌共同感染引起的社区获得性坏死性肺炎的成人病例,加深对坏死性肺炎和中毒性休克综合征的理解。

方法

回顾性分析一名入住重症监护病房(ICU)的甲型流感病毒(H1N1)与金黄色葡萄球菌共同感染患者的临床资料。

结果

该患者表现出病毒与金黄色葡萄球菌共同感染的典型临床表现,包括坏死性肺炎和中毒性休克综合征。在患者的支气管肺泡灌洗液中检测到金黄色葡萄球菌的LukS - PV和LukF - PV毒力因子基因。不幸的是,尽管及时给予了抗病毒药物(奥司他韦)、抗生素(利奈唑胺、亚胺培南 - 西司他丁)以及用于抗炎的糖皮质激素,但患者病情仍逐渐恶化,最终导致死亡。

结论

临床医生应警惕流感病毒与金黄色葡萄球菌的共同感染,尤其是当后者携带毒力因子时。金黄色葡萄球菌毒力因子基因的存在可导致预后不良的坏死性肺炎。这是一个特别值得关注的问题,因为这两种感染对年轻人都可能危及生命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d8/11388272/8a008f049fe0/gr1.jpg

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