頁籤選單縮合
題名 | Nocardia Pneumonia in an Immunocompetent Patient: A Case Report=土壤菌絲屬(Nocardia)肺炎發生在一位免疫力正常病人身上:病例報告 |
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作者 | 王威勝; 曾祥洸; 劉昌邦; 李聰明; Wang, Wei-Sheng; Tseng, Hsiang-Kuang; Liu, Chang-Pan; Lee, Chun-Ming; |
期刊 | 內科學誌 |
出版日期 | 20080600 |
卷期 | 19:3 2008.06[民97.06] |
頁次 | 頁270-274 |
分類號 | 415.463 |
語文 | chi |
關鍵詞 | Nocardia; Pneumonia; |
中文摘要 | 土壤菌絲屬 (Nocadia) 肺炎在台灣是相當罕見的肺部感染疾病,感染通常和接觸泥土或污染的水有關。一個 39 歲免疫力正常的病患因工安意外跌落而產生多處傷口及骨折以及吸入河水及泥土,病患的住院病程中有產氣單胞菌 (aeromonas species) 感染造成壞死性筋膜炎及感染 acinetobacter species 肺炎。儘管使用了 meropenem 但是病患肺炎狀況持續惡化,直到支氣管沖洗術之革蘭氏染色及痰液培養出土壤菌絲屬 (Nocardia) 後,調整抗生素並以 trimethoprim-sulfamethoxazole 及 meropenem 合併使用後臨床狀況才顯著改善。從這個病例,我們可以學到當病患有接觸泥土或受到污染的水的病史時,而且病患對於治療社區型肺炎的抗生素毫無反應時,必須將土壤菌絲屬 (Nocardia) 肺炎列入鑑別診斷。 |
英文摘要 | Nocardia pneumonia is a relatively rare lung infection in Taiwan. It is usually related to contact with soil or contaminated water. A 39-year-old previously healthy man had a work-related fall resulting in multiple wounds and fractures as well as aspiration of river water and soil. His hospital course was complicated by facial necrotizing fasciitis due to aeromonas species and acinetobacter pneumonia. Despite meropenem treatment for the latter, his pneumonia failed to resolve. Gram stain of fluid from bronchoalveolar lavage demonstrated nocardia, and he improved after trimethoprim-sulfamethoxazole added to the meropenem he was already receiving. When a patient with pneumonia has a history of soil or river water aspiration and the lung infection responds poorly to antimicrobial therapy for community-acquired pneumonia, pulmonary nocardiosis should be considered and a careful search performed for evidence of the organism is necessary. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。