宏基因组二代测序诊断鼻疽诺卡菌病1例及文献复习

Diagnosis of nocardia farcinica by metagenomic next-generation sequencing:a case and literature review

诺卡菌是一种存在于土壤、水域及空气中的条件致病菌。诺卡菌病是由诺卡菌引起的人畜共患病,呼吸道为主要传染途径,亦可经皮肤创面进入人体,引起肺、脑、皮肤及软组织感染,导致脓胸者罕见。经外周血病原体宏基因组二代测序(metagenomic next-generation sequencing,mNGS)检出鼻疽诺卡菌鲜有报道。早期诊断及治疗可显著改善患者预后。本文报道1例经mNGS确诊,由鼻疽诺卡菌引起的肺部感染、脓胸及菌血症病例,旨在加深医务人员对诺卡菌病的认知。

Nocardia is an opportunistic pathogen found in soil,water and air.Nocardiosis is a zoonotic disease caused by Nocardia,with respiratory track as the main transmission route,and can also enter the human body through skin wounds,causing infection of the lungs、brain、skin and soft tissue,and rarely causing empyema.There are relatively few reports of Nocardiosis detected through metagenomic next-generation sequencing in peripheral blood.This paper reports a case of pulmonary infection,empyema and bacteremia caused by Nocardia farcinica,diagnosed by mNGS,aimed at to deepened the cognition of medical staff about the nocardiosis,early diagnosis and treatment can significantly improve the prognosis of patients.