艾滋病合并马红球菌感染1例并文献复习

马红球菌是人类感染性疾病谱中一个较为罕见的病原体,但在获得性免疫缺陷综合症患者中已成为一种机会性致病性病原体。通常表现为亚急性肺炎,多数为空洞性肺炎,有时甚至是细菌性肺炎。虽然在自然界分布广,但是从临床和微生物学的方面来诊断马红球菌感染仍然具有挑战性,目前还没有建立标准的治疗方案。此次报道分析一例艾滋病合并马红球菌性肺炎及败血症患者的详细情况。患者为29岁男性,以咳嗽、咳痰、发热为主要临床表现,肺脏组织镜下见灶状坏死,中性粒细胞和浆细胞浸润,无明显的干酪样坏死。痰液、骨髓、肺脓肿均培养出马红球菌。我们描述马红球菌的临床特点,强调早期诊断及联合抗生素治疗的重要性,为持续进行抗逆转录病毒治疗做好准备。

Disseminated Rhodococcus equi infection in a patient in advanced HIV and literature review

Rhodococcus equi is an unusual cause of infection in human, but has emerged as an opportunistic pathogen among acquired immunodeficiency syndrome patients. The disease is usually presented as subacute pneumonia that is mostly cavitary and sometimes bacteremic. Although the spectrum of disease is broad, Rhodococcus equi infections remains challenging, both from clinical and microbiological view,and no standard treatment has been established. In this report, we present a detailed case of acquired immunodeficiency syndrome combined with Rhodococcus equi. A 29-year-old male who represented with cough, expectoration and fever. Lung histopathological examination showed focal necrosis, infiltration by neutrophils, plasma cells and macrophages, no caseous necrosis. Blood culture and culture of sputum,empyema and bone marrow were positive for Rhodococcus equi. We describe the clinical features of Rhodococcus equi infections, highlight the importance of an early diagnosis and combined parenteral antibiotics, which prepares for continued antiretroviral therapy.