免疫功能正常宿主肺孢子菌肺炎1例并文献复习

A Case of Pneumocystis Pneumonia in Normal Host with Immune Function and Literature Review

对1例免疫功能正常的肺孢子菌肺炎(PCP)患者的临床资料、实验室及影像学检查、肺泡灌洗液病原微生物宏基因组结果及治疗情况进行回顾性分析,结合相关文献,探讨PCP的病因及机制、临床表现、诊断及治疗方法,从而提高临床认识。PCP多表现为发热,咳嗽,不同程度呼吸困难,计算机断层扫描(CT)可显示弥漫“磨玻璃”改变,联合免疫荧光镜检/聚合酶链式反应(PCR)/血清G试验可提高微生物检测率,但“下一代”测序技术(NGS)可协助精准快速确定致病菌。但是耶氏肺孢子菌致免疫正常宿主肺部感染相对罕见,应尽早完善病原学,尽量寻找基础疾病和可能的病因。

A case of normal immune function of pneumocystis pneumonia(PCP)in patients with clinical data,laboratory and imaging examination,alveolar lavage pathogenic microbial metagenomics results and treatment situation were analyzed retrospectively,in combination with related literature,investigate the etiology and mechanism of PCP,clinical manifestation,diagnosis,and treatment method,so as to improve clinical knowledge.PCP much characterized by fever,cough and difficulty breathing,different level of computer tomography(CT)showed diffuse"ground glass"change,joint immunofluorescence microscopy/polymerase chain reaction(PCR)/G serum tests can increase the rate of microbial detection,but the"next-generation"sequencing(NGS)can help the accuracy to determine pathogenic bacteria quickly.However,pulmonary infection caused by Pneumocystis jirovecii in immune normal host is relatively rare,so it is necessary to improve the etiology as soon as possible,and try to find the underlying diseases and possible causes.