耐多药肺结核合并烟曲霉、甲型H1N1流感病毒感染1例并文献复习

A case of multidrug-resistant pulmonary tuberculosis combined with Aspergillus fumigatus and H1N1 influenza and literature review

患者,男,61岁,农民,因“反复咳嗽8年,加重伴发热1 d”入院,入院后予抗结核治疗、奥司他韦抗病毒治疗、伏立康唑抗真菌治疗等,治疗过程中关注CYP2C19基因检测、血药浓度、药物相互作用、不良反应、肝肾功能监测,经治疗后患者症状好转出院。耐多药肺结核合并侵袭性曲霉菌、甲型H1N1流感病毒感染,精准诊疗是关键,同时开展抗结核、真菌、病毒治疗可能会加重肝肾功能负担,精准用药剂量的把控,药物间的相互作用都是需要重点关注的内容。该文旨在提高对耐多药肺结核合并烟曲霉、甲型H1N1流感病毒感染病例的认识。

A 61-year-old male farmer was admitted to the hospital due to recurrent cough for 8 years,worsening with fever for 1 day.After admission,he received anti tuberculosis treatment,oseltamivir antiviral treatment,voriconazole antifungal treatment,etc.During the treatment process,attention was paid to CYP2C19 gene testing,blood drug concentration,drug interaction,adverse reactions,and liver and kidney function monitoring.After treatment,the patient's symptoms improved and he was discharged.The precise diagnosis and treatment of multidrug-resistant pulmonary tuberculosis combined with invasive Aspergillus and influenza A/H1N1 virus infection are crucial.At the same time,carrying out anti tuberculosis,fungal,and viral treatments may increase the burden on liver and kidney function.The control of precise drug dosage and drug interactions are all important aspects that need to be focused on.This article aims to improve understanding of cases of multidrug-resistant pulmonary tuberculosis combined with Aspergillus fumigatus and influenza A/H1N1 virus infection.