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一例甲型流感病毒感染后重症肺炎,经FilmArray肺炎检测板及支气管肺泡灌洗确诊

A Severe Case of Pneumonia Following Influenza A Virus Infection Diagnosed by FilmArray Pneumonia Panel and Bronchoalveolar Lavage.

作者信息

Matsuda Koji, Yokoo Keiki, Toshima Yoshikazu, Kamada Koki, Nagao Takayuki, Kikuchi Koki, Shimizu Takafumi, Onishi Shinsuke, Nara Satoshi, Yokoyama Takeshi, Yamada Gen

机构信息

Department of Respiratory Medicine Teine Keijinkai Hospital Sapporo Japan.

Internal Medicine Residency Program Teine Keijinkai Hospital Sapporo Japan.

出版信息

Respirol Case Rep. 2025 Jul 10;13(7):e70267. doi: 10.1002/rcr2.70267. eCollection 2025 Jul.

Abstract

A previously healthy 63-year-old woman, unvaccinated for influenza A, had a mild fever for a week followed by alerted consciousness. On the day of admission, she developed shortness of breath, high fever, hypotension and alterations of consciousness. Chest CT revealed rapidly progressing bilateral infiltrates. She was diagnosed with disseminated intravascular coagulation, hypogammaglobulinemia and acute renal failure, requiring intensive care for respiratory failure and hypotension. A Sputum FilmArray Pneumonia Panel (PN panel) performed on admission identified multiple pathogens, including influenza A virus and (), although only was cultured from bronchoalveolar lavage fluid. Intensive care, including antibiotics and steroids, led to clinical improvement. Blood cultures remained negative throughout the course. Even healthy adults can develop severe pneumonia following influenza A infection. Rapid bacterial identification by PN panel and bronchoscopy, along with an appropriate treatment strategy, may improve outcomes.

摘要

一名63岁既往健康的女性,未接种甲型流感疫苗,出现低热一周,随后意识不清。入院当天,她出现呼吸急促、高热、低血压和意识改变。胸部CT显示双侧浸润迅速进展。她被诊断为弥散性血管内凝血、低丙种球蛋白血症和急性肾衰竭,因呼吸衰竭和低血压需要重症监护。入院时进行的痰FilmArray肺炎检测板(PN检测板)鉴定出多种病原体,包括甲型流感病毒和(),尽管支气管肺泡灌洗液仅培养出()。包括抗生素和类固醇在内的重症监护使病情得到临床改善。整个病程血培养均为阴性。即使是健康成年人,甲型流感感染后也可能发展为重症肺炎。通过PN检测板和支气管镜快速鉴定细菌,以及采取适当的治疗策略,可能改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb35/12241819/303bcdd5072d/RCR2-13-e70267-g003.jpg

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