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通过支气管肺泡灌洗液的FilmArray分析诊断的大环内酯耐药性肺炎支原体所致弥漫性肺泡出血

Diffuse Alveolar Hemorrhage Due to Macrolide-Refractory Mycoplasma pneumoniae Diagnosed by FilmArray Analysis of Bronchoalveolar Lavage Fluid.

作者信息

Nakashima Tatsumi, Yanagihara Toyoshi, Sanai Rei, Fujimoto Yuta, Nakao Akira, Shundo Yuki, Hamada Naoki, Ebi Noriyuki, Inoue Hiroyuki, Fujita Masaki

机构信息

Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, JPN.

出版信息

Cureus. 2024 Dec 11;16(12):e75525. doi: 10.7759/cureus.75525. eCollection 2024 Dec.

Abstract

typically causes mild respiratory infections but can rarely lead to severe complications. We report a case of a 43-year-old immunocompetent male who presented with progressive dyspnea and respiratory failure with bilateral pulmonary infiltrates, refractory to outpatient treatment with azithromycin, ceftriaxone, and levofloxacin. Bronchoscopy revealed multiple white plaques in the trachea and diffuse alveolar hemorrhage. Although initial throat loop-mediated isothermal amplification (LAMP) testing for was negative, FilmArray analysis of bronchoalveolar lavage fluid successfully detected The patient improved with minocycline and methylprednisolone treatment. This case demonstrates that can cause severe complications, including diffuse alveolar hemorrhage, even in immunocompetent patients. In some cases, it highlights the importance of lower respiratory tract sampling for accurate diagnosis.

摘要

通常会引起轻度呼吸道感染,但很少会导致严重并发症。我们报告一例43岁免疫功能正常的男性病例,该患者表现为进行性呼吸困难和呼吸衰竭,伴有双侧肺部浸润,门诊使用阿奇霉素、头孢曲松和左氧氟沙星治疗无效。支气管镜检查发现气管内有多个白色斑块及弥漫性肺泡出血。尽管最初的咽拭子环介导等温扩增(LAMP)检测结果为阴性,但支气管肺泡灌洗液的FilmArray分析成功检测到了[病原体名称未给出]。患者接受米诺环素和甲泼尼龙治疗后病情好转。该病例表明,[病原体名称未给出]即使在免疫功能正常的患者中也可导致严重并发症,包括弥漫性肺泡出血。在某些情况下,它凸显了下呼吸道采样对于准确诊断的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/529b/11720268/c595573651ac/cureus-0016-00000075525-i01.jpg

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