静脉吸毒所致重症金黄色葡萄球菌肺炎临床特征:3例并文献复习

Clinical features of severe Staphylococci aureus pneumonia induced by dope injection:report of 3 cases and review of literature

目的探讨静脉吸毒所致重症金黄色葡萄球菌(金葡菌)肺炎患者的临床特征,提高对吸毒所致的金葡菌肺炎的认识。方法回顾性分析2009年南京市鼓楼医院呼吸内科收治的3例重症金葡菌肺炎患者的临床资料,并对相关文献进行复习。结果 3例患者均为年轻患者,就诊时隐瞒吸毒史,均出现明显的低血压或休克、肝肾功能损害,血小板低下,机体消耗显著,表现出明显的低蛋白血症、贫血以及氮质血症,而呼吸系统症状轻微;胸部影像学出现典型的肺浸润、肺气囊/空洞、肺脓肿、胸水;血/痰培养均出现耐甲氧西林金葡菌生长,给予有效的综合治疗后患者痊愈。结论静脉吸毒者重症金葡菌肺炎全身中毒症状重,呼吸系统症状轻,影像学特征具有诊断意义,选取以敏感的抗生素为基础的综合治疗是治愈的关键。

Objective To explore clinical characteristics of patients with severe Staphylococci aureus pneumonia induced by dope injection and improve the understanding of the disease.Methods Clinical data of 3 intravenous drug patients with Staphylococci aureus pneumonia in 2009 were reviewed and the related literature was reviewed.Results All 3 cases were young patients and hid the truth of the drug abuse.They presented hypotension,liver and kidney dysfunction,thrombocytopenia,hypoproteinemia,anaemia and azotemia,but had mild respiratory symptoms.The radiologic findings include lung infiltration,lung aerocyst,lung cavities,lung abscess and pleural efflusion.The cultures of blood or sputum were methicillin-resistant Staphylococci aureus.The patients recovered after effective combined therapy.Conclusion Intravenous drug abusers with severe Staphylococcs aureus pneumonia presented severe toxic symptom,light symptom of respiratory system and the typical radiologic findings that can suggest the diagnosis.Combined therapy based on sensitive antibiotics is the key to the patients.