Clin Lab. 2024 Oct 1;70(10). doi: 10.7754/Clin.Lab.2024.240530.
Influenza is an acute respiratory infection caused by influenza viruses, with influenza A virus (IAV) being the most common and most likely to progress to critically ill cases leading to death. Pneumocystis jiroveci is an opportunistic lung-causing fungus that occurs most often in immunocompromised individuals and can cause Pneumocystis jiroveci pneumonia (PJP). It is rare for both diseases to occur in the same patient.
Appropriate laboratory tests, chest computed tomography (CT), bronchoalveolar lavage fluid, second-generation macro gene sequencing, and pathogenetic tests to clarify the diagnosis.
G test and LDH were high, and chest CT showed rapidly progressive interstitial pneumonia, which was confirmed by bronchoalveolar lavage fluid and macrogenomic second-generation sequencing (mNGS) to be a mixed infection of H. influenzae type A virus and Pneumocystis jiroveci.
In rapidly progressive interstitial pneumonia, bronchoalveolar lavage and mNGS should be done early to clarify the presence of infection with specific pathogenic organisms.
流感是由流感病毒引起的急性呼吸道感染，其中甲型流感病毒（IAV）最为常见，且最有可能发展为导致死亡的重症病例。卡氏肺孢子虫是一种机会性肺部真菌，最常发生在免疫功能低下的个体中，并可导致卡氏肺孢子虫肺炎（PJP）。两种疾病同时发生在同一患者身上的情况很少见。
进行适当的实验室检查、胸部计算机断层扫描（CT）、支气管肺泡灌洗液、第二代宏基因组测序和病原体检测以明确诊断。
G 试验和 LDH 升高，胸部 CT 显示快速进展性间质性肺炎，经支气管肺泡灌洗液和第二代宏基因组测序（mNGS）证实为甲型流感病毒和卡氏肺孢子虫的混合感染。
在快速进展性间质性肺炎中，应尽早进行支气管肺泡灌洗和 mNGS，以明确是否存在特定病原体感染。
