嗜麦芽窄食单胞菌肺炎的CT影像表现

CT Findings of Stenotrophomonas Maltophilia Pneumonia

目的探讨嗜麦芽窄食单胞菌(S.maltophilia)肺炎的肺部CT表现特征。方法回顾性分析经病原体检测和临床判断确定嗜麦芽窄食单胞菌肺炎的7例患者临床及影像资料,观察患者肺部CT病灶的密度、形态、位置、伴随征象及其变化情况。结果 7例患者肺组织异常均表现为磨玻璃影(GGO)或合并实变影,6例患者病灶分布于两侧肺叶,6例合并两侧或单侧胸腔积液,6例无明显的位置分布规律。其他辅助征象包括充气支气管征4例、小叶间隔增厚或胸膜下线3例、纵隔淋巴结肿大2例、树芽征1例。5例免疫功能正常患者得到有效治疗后病灶吸收好转,1例免疫功能不全患者病灶明显进展。结论嗜麦芽窄食单胞菌肺炎CT表现为斑片状GGO或合并实变影,常累及两侧肺叶、合并两侧或单侧胸腔积液,还可出现充气支气管征、小叶间隔增厚、树芽征、纵隔淋巴结肿大等征象。

Objective To explore the CT manifestations of Stenotrophomonas maltophiliapneumonia. Methods CT findings of 7 patients with Stenotrophomonas maltophilia pneumonia confirmed by pathogen detection and clinical judgment were retrospectively analyzed.The density、shape、location and associated findings of the lesions on CT images was observed. Results Seven patients showed ground glass opacity(GGO) or mergering consolidation.Six patients showed in both the lungs, six patients were complicated with bilateral or unilateral pleural effusions and six patients had no obvious distribution pattern.Associated findings included air-bronchogram in 4 cases, septal thickening or subpleural line in 3 cases, lymphadenopathy in 2 cases, and tree-in-bud in 1 case.5 immunocompetent patients had improved after effective treatment, but 1 immunocompromised patient had significantly worsen. Conclusion CT manifestations of Stenotrophomonas maltophilia pneumonia showed patchy GGO or mergering consolidation, often involving both the lungs, combined with bilateral or unilateral pleural effusions, and signs such as air-bronchogram, septal thickening, tree-in-bud, and lymphadenopathy.