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楔形切除术及侵袭性肺真菌感染和长期新冠综合征的最佳解决方案——病例报告及文献综述

Wedge Resection and Optimal Solutions for Invasive Pulmonary Fungal Infection and Long COVID Syndrome-A Case Report and Brief Literature Review.

作者信息

Mosteanu Ioana-Madalina, Mahler Beatrice, Parliteanu Oana-Andreea, Stoichita Alexandru, Matache Radu-Serban, Marghescu Angela-Stefania, Filip Petruta-Violeta, Mota Eugen, Vladu Mihaela Ionela, Mota Maria

机构信息

"Marius Nasta" Institute of Pneumophtiziology, 050159 Bucharest, Romania.

Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

出版信息

Reports (MDPI). 2024 Apr 5;7(2):25. doi: 10.3390/reports7020025.

Abstract

A rise in fungal infections has been observed worldwide among patients with extended hospital stays because of the severe infection caused by the new coronavirus pandemic. A 62-year-old female patient was admitted with a severe form of Coronavirus disease 2019 (COVID-19) and spent four weeks in the intensive care unit (ICU) requiring mechanical ventilation support before being moved to a tertiary hospital for further testing. filamentous fungus, spp., and positive bacteriology for multidrug-resistant Klebsiella pneumoniae and Proteus mirabilis were identified by bronchial aspirate cultures. The patient's progress was gradually encouraging while receiving oral antifungal and broad-spectrum antibiotic therapy along with respiratory physical therapy; but ultimately, thoracic surgery was necessary. Long-lasting tissue damage and severe, persistent inflammatory syndrome were the two main pathophysiological mechanisms that led to significant outcomes regarding lung lesions that were rapidly colonized by fungi and resistant flora, cardiac damage with sinus tachycardia at the slightest effort, and chronic inflammatory syndrome, which was characterized by marked asthenia, myalgias, and exercise intolerance.

摘要

由于新型冠状病毒大流行导致的严重感染,全球范围内住院时间延长的患者中真菌感染有所增加。一名62岁女性患者因严重的2019冠状病毒病(COVID-19)入院,在重症监护病房(ICU)接受了四周的机械通气支持,之后转至三级医院进行进一步检查。支气管抽吸物培养鉴定出丝状真菌、 属,以及耐多药肺炎克雷伯菌和奇异变形杆菌的阳性细菌学结果。在接受口服抗真菌和广谱抗生素治疗以及呼吸物理治疗的同时,患者的病情逐渐令人鼓舞;但最终,胸外科手术是必要的。长期的组织损伤和严重、持续的炎症综合征是导致显著后果的两个主要病理生理机制,这些后果包括肺部病变迅速被真菌和耐药菌群定植、稍有用力就出现窦性心动过速的心脏损伤以及以明显乏力、肌痛和运动不耐受为特征的慢性炎症综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1209/12225501/3773faf921b7/reports-07-00025-g001.jpg

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