摘要
目的 分析肺奴卡菌病的临床表现、影像学和实验室检查特点.方法 回顾性分析2012年1月至2014年4月广州医科大学附属第一医院收治的7例肺奴卡菌病患者的临床资料,包括病史、症状及体征、影像学和实验室检查资料、病原学特点和诊治情况.结果 肺奴卡菌病患者7例中,既往体健者2例、有基础疾病者5例,有应用免疫抑制剂或糖皮质激素治疗病史者2例.临床症状表现为咳嗽7例、咳痰7例、发热4例、气促3例、胸痛1例、咯血1例、消瘦1例.胸部高分辨率CT检查表现为单个或多发结节影3例,实变影3例,肺部肿块影1例,其中伴有空洞3例、纵膈淋巴结肿大2例、胸腔积液3例.7例肺奴卡菌病患者中,检出巴西奴卡菌3株,星形奴卡菌1株,未分型奴卡菌3株.多数患者磺胺类药物治疗有效.结论 肺奴卡菌病患者多有基础疾病,临床表现无特异性,影像学检查以肺部单个或多发结节影及实变影多见,磺胺类药物对多数患者治疗有效.
Objective To analyze the clinical features,characteristics of imaging and laboratory examination of pulmonary nocardiosis.Methods The clinical data of 7 patients with pulmonary nocardiosis admitted to the First Affiliated Hospital of Guangzhou Medical University from January 2012 to April 2014 were retrospectively analyzed,including medical history,symptoms and signs,imaging and laboratory data,etiologic features and management.Results Of 7 patients,2 were otherwise healthy,and 5 were with underlying diseases.Two patients had been treated with immunosuppressants or glucocorticoids.The clinical manifestations included cough （n=7）,expectoration （n=7）,fever （n=4）,dyspnea （n=3）,chest pain （n=1）,hemoptysis （n=1） and emaciation （n=1）.Pulmonary high-resolution CT scan revealed single or multiple nodular shadows （n=3）,infiltrates （n=3）,lung masses （n=l）,complicated with cavity formation （n=3）,mediastinal lymphadenectasis （n=2）,and pleural effusion （n=3）.Among 7 patients with pulmonary nocardiosis,there were 3 strains of Nocardia brasiliensis,1 of Nocardia asteroids,and other 3 of nonclassified Nocardia.Sulfonamides were effective for most patients.Conclusions Most patients with pulmonary nocardiosis may have underlying diseases with nonspecific clinical manifestations.Single or multiple pulmonary nodules and infiltrates are the most common presentation in imaging studies.Sulfonamides are effective for most of the patients.
出处
《中华生物医学工程杂志》
CAS
2014年第3期244-247,共4页
Chinese Journal of Biomedical Engineering
关键词
肺奴卡菌病
细菌感染
体层摄影术
X线计算机
Pulmonary nocardiosis Bacterial infections Tomography,X-ray computed
