Van Den Bosch Thomas, De Muynck Benedicte, Bomans Peter, Granacher Nikki
Pulmonology, Ziekenhuis aan de Stroom, Antwerp, BEL.
Hematology, Ziekenhuis aan de Stroom, Antwerp, BEL.
Cureus. 2025 Jun 7;17(6):e85511. doi: 10.7759/cureus.85511. eCollection 2025 Jun.
We present a challenging case of lung abscess in a 58-year-old woman with myelodysplastic syndrome presenting with a cavitary lung lesion. The diagnostic workup was complicated by a false-positive galactomannan result, resulting in unnecessary medicamentous treatment and possible different therapeutic decisions. Management involved surgical resection regarding a necessary stem cell transplant and prolonged antibiotic (with monotherapy versus broad-spectrum) and antifungal therapy. This case highlights the need to consider atypical pathogens in immunocompromised patients, even when other findings suggest more common infections, and underscores the importance of a multidisciplinary approach and careful interpretation of laboratory results to guide appropriate management strategies.
我们报告了一例具有挑战性的病例，一名58岁患有骨髓增生异常综合征的女性出现肺部空洞性病变，诊断为肺脓肿。半乳甘露聚糖检测结果呈假阳性，使诊断检查变得复杂，导致了不必要的药物治疗以及可能不同的治疗决策。治疗措施包括考虑到必要的干细胞移植而进行手术切除，以及延长抗生素（单药治疗与广谱治疗）和抗真菌治疗。该病例强调，即使其他检查结果提示更常见的感染，对于免疫功能低下的患者也需要考虑非典型病原体，同时突出了多学科方法以及仔细解读实验室结果以指导恰当管理策略的重要性。
