基于高通量测序诊断肺隐球菌病1例并文献复习

Diagnosis of pulmonary cryptococcosis based on high throughput sequencing:a case report and literature review

本文介绍1例患有甲状腺功能亢进症基础疾病的15岁男性患者,因咳嗽伴发热在当地医院就诊,考虑社区获得性肺炎,予经验性用药10 d后复查影像学出现病情发展,遂转入本院。经初始抗感染治疗无效,遂行肺泡灌洗液高通量测序发现肺隐球菌,并行肺组织穿刺活检证实为肺隐球菌病,更改治疗策略予抗真菌药物治疗病情迅速好转。社区获得性肺炎常见病原体为肺炎链球菌、肺炎支原体,在社区获得性肺炎初始治疗失败的诊治过程中,应动态评估、考虑特殊病原体的可能性,并及时行高通量测序检验有助于明确诊断、减少住院天数。

This paper introduces a 15-year-old male patient with basic diseases of hyperthyroidism,seeing a doctor in a local hospital due to cough and fever,he is considered community-acquired pneumonia,after 10 days of empirical medication,the imaging results showed the progress of the disease,so he was transferred to our hospital.After the initial anti infective treatment was ineffective,pulmonary Cryptococcus was found by high-throughput sequencing of alveolar lavage fluid,pulmonary cryptococcosis was confirmed by lung biopsy,after changing the treatment strategy and using antifungal drugs,the condition improved rapidly.The common pathogens of community-acquired pneumonia are Streptococcus pneumoniae and Mycoplasma pneumoniae,during the diagnosis and treatment of initial treatment failure of community-acquired pneumonia,we should dynamically evaluate and consider the possibility of special pathogens,and timely conduct high-throughput sequencing test,which is helpful to clarify the diagnosis and reduce the length of hospital stay.