1例盖尔森基兴诺卡菌血流感染病原学诊断报告

A Etiological diagnosis case report of Nocardia cyriacigeorgica bloodstream infection

目的加强对诺卡菌病的认识,以提升其临床诊疗水平。方法回顾分析乐山市人民医院肾病内科的1例盖尔森基兴诺卡菌血流感染的临床资料,包括临床表现、实验室检查、影像学检查、诊疗情况等。结果此病人的临床表现及影像学检查缺乏特异性,检验人员镜检发现其革兰氏染色涂片结果为革兰阳性、分枝状长杆菌,细菌的16S rRNA测序分析证实为盖尔森基兴诺卡菌。结论诺卡菌病多发生于机体免疫受损及合并慢性基础疾病的人群,临床表现和影像学缺乏特异性,诊断需依赖于病原学检查,合格标本的采集和革兰氏染色对诺卡菌病是早期诊断及正确治疗的重要步骤。

Nocardiosis is a rare but the severe opportunistic infectious disease, usually occur in the population with immune impairment and chronic diseases. The clinical manifestation and radiological examinations are nonspecific, and the diagnosis for the disease mostly depends on the laboratory examination. To strengthen the understanding of nocardiosis and improve the diagnosis and treatment of bloodstream infection due to Nocardia, the clinical data of a patient with Nocardia cyriacigeorgica bloodstream infection was retrospectively analyzed and the related literatures at home and abroad were reviewed. The clinical and radiological features of the patient were nonspecific. The diagnose was depended on the etiology examination in the laboratory. Gram-positive rod was detected. Subsequently, 16 s rRNA sequencing of the bacteria was confirmed to be N. cyriacigeorgica. These results indicated that qualified sample collection and Gram staining. are critical for early diagnosis of nocardiosis.