| 刘克琴,张潇月,刘海霞,等.脑瘫病人星座链球菌感染肺脓肿 1例[J].安徽医药,2021,25(7):1366-1368. |
| 脑瘫病人星座链球菌感染肺脓肿 1例 |
| A case report and literature review of streptococcus constellatus lung abscesses in patients with cerebral palsy |
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| DOI：10.3969/j.issn.1009-6469.2021.07.023 |
| 中文关键词: 星座链球菌 肺脓肿 脑性瘫痪 |
| 英文关键词: Streptococcus constellatus Lung abscess Cerebral palsy |
| 基金项目:2015年度河南省医学科技攻关计划项目( 201504057) |
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| 中文摘要: |
| 目的探讨肺脓肿的病原学流行病学特征、星座链球菌感染的特点、星座链球菌肺脓肿的诊治要点，从而改善肺脓肿病人的临床预后。方法 2019年 3月于江苏省第二中医院急诊病区住院的脑瘫病人星座链球菌感染致肺脓肿一例的诊治过程并复习相关文献。该病人自幼有“脑瘫、癫痫”病史， 1周前开始咳嗽， 3d前出现发热，伴有呼吸困难，胸部 CT出现巨大空腔、两肺炎症，诊断考虑肺脓肿、吸入性肺炎，同时合并中度贫血、严重低蛋白血症，给予脓肿穿刺引流、冲洗，同时予抗感染、输血、输白蛋白及营养支持等治疗后病情好转。结果脓液培养为星座链球菌，经过抗感染治疗、脓肿穿刺引流，脓肿逐渐消失，贫血纠正，血浆白蛋白恢复正常。结论星座链球菌培养条件高，需放置 5％二氧化碳，或厌氧环境以促其生长，故实验室易漏检，同时星座链球菌对多种抗生素，尤其青霉素及其衍生物有较高的敏感性，因而星座链球菌所致感染可能被临床医生忽视。 |
| 英文摘要: |
| Objective To explore the etiological and epidemiological characteristics of pulmonary abscess, the characteristics ofstreptococcus constellatus infection, and the key points of diagnosis and treatment of streptococcus constellatus pulmonary abscess, soas to improve the clinical prognosis of patients with pulmonary abscess.Methods The diagnosis and treatment of 1 case of pulmonaryabscess caused by streptococcus constellatus admitted to Jiangsu Second Chinese Medicine Hospital in March 2019 was studied andrelevant literature was reviewed. The patient had a history of "cerebral palsy and epilepsy". He started coughing a week ago, and developed a fever three days ago, associated with dyspnea. There was a large cavity on chest CT. The diagnosis was lung abscess, aspirationpneumonia, accompanied moderate anemia, severe hypoalbuminemia. The patient was treated with puncture, drainage, and flushing ofpulmonary abscess, at the same time, antibiotic therapy, transfusions of blood and albumin, and nutrition support were performed.Re? sults Streptococcus constellatus was found into the purulent liquid, after active anti-infection and puncture and drainage of the abscess, the abscess disappeared gradually, anemia was corrected, and plasma albumin returned to normal.Conclusion Streptococcusconstellatus belongs to streptococcus miller groups, which is an important pathogen of pneumonia and purulent infection. Streptococcusconstellatus is cultivated difficultly, which should be placed in 5% CO2, or anaerobic environment in order to promote its growth, so it iseasy to miss the diagnosis. At the same time, Streptococcus constellatus have a high sensitivity to multiple antibiotics, especially penicillin and its derivatives. Therefore, infection by Streptococcus constellatus may be ignored by the clinician. |
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