豚鼠耳炎诺卡菌肺部感染病例1例

Pulmonary Infection Caused by Nocardia Otitidis: A Case Report

肺诺卡菌病临床较为少见,且常继发于COPD、免疫缺陷、糖尿病、肿瘤疾病或长期使用激素及免疫抑制剂药物患者,并且也有国内外报道正常健康人也可见该病的发生,但很少见,该病的影像学易与结核、肿瘤、真菌感染等混淆,现有临床诊断方法较少,目前主要以寻找病原菌为主要确诊方法,而该菌培养周期长易被漏诊,同时一些痰液净化溶液对诺卡氏菌属有毒,特别是氢氧化钠、N乙酰半胱氨酸和苯扎氯铵,会出现假阴性结果。本文主要通过报道青海大学附属医院收治的豚鼠耳炎诺卡菌肺部感染病例1例,并搜索国内外相关文献,对国内外现有诊疗方案进行探讨,希望能给予临床医生及研究者们对诺卡菌病有进一步的认识,方便后期临床工作顺利进行。

Pulmonary candidiasis is rare in clinical practice, and is often secondary to COPD, immunodeficiency, diabetes, tumor diseases or patients who have been treated with hormones and immuno-suppressive agents for a long time. It has also been reported at home and abroad that the occur-rence of the disease can also be seen in normal healthy people, but it is rare. The imaging of the disease is easy to be confused with tuberculosis, tumors, fungal infections, etc. There are few ex-isting clinical diagnostic methods. At present, the main diagnostic method is to find the pathogen, and the culture cycle of the bacterium is long and easy to be missed. At the same time, some sputum purification solutions are toxic to Nocardia;especially for sodium hydroxide, N acetylcysteine and benzalkonium chloride, false negative results will occur. In this paper, we mainly report a case of Nocardia otitidis pulmonary infection in guinea pigs admitted to the Affiliated Hospital of Qinghai University, and search the relevant domestic and foreign literatures to discuss the existing diagnosis and treatment options at home and abroad, hoping to give clinicians and researchers a further understanding of Nocardiosis and facilitate the smooth progress of clinical work in the later stage.