普雷沃氏菌感染致肺脓肿特征分析

目的探讨普雷沃氏菌及其感染导致的肺脓肿的诊断学特征。 方法回顾性分析2021年8月22日西部战区总医院呼吸与危重症医学科收治的1例普雷沃氏菌感染所致肺脓肿患者的临床相关资料，查阅并复习与之相关的文献资料。 结果51岁男性患者以发热伴胸痛就诊，经常规痰液、胸腔积液及血液细菌培养均未发现明确致病菌，血常规及降钙素原等感染指标明显升高，胸部CT提示肺脓肿形成，经验性先后予以美罗培南、莫西沙星、甲硝唑抗感染治疗近1个月无效。灌洗液及血液宏基因组二代测序(mNGS)技术明确致病菌为普雷沃氏菌，进而针对病原学治疗，患者病情好转。 结论普雷沃氏菌是一种条件致病菌，当感染患者经常规经验性治疗无效时，mNGS技术在复杂性感染病原学诊断中具有重要价值和意义，值得在临床上进一步推广。

Characteristics analysis of pulmonary abscess caused by Prevotella infection

ObjectiveTo investigate the diagnostic characteristics of pulmonary abscess caused by Prevotella. MethodsThe clinical data of 1 patient who was admitted to the Department of Respiratory and Critical Care Medicine of General Hospital of Western Theater Command on August 22, 2021 was retrospectively collected and the related literatures were reviewed. ResultsA 51-year-old male patient with fever and chest pain had no obvious pathogenic bacteria in routine sputum, pleural effusion, and blood bacterial cultures. The infection indicators, such as procalcitonin and blood routine, were significantly elevated, and the chest computed tomography (CT) scans revealed the development of lung abscess. Meropenem, moxifloxacin, and metronidazole were used as an initial anti-infective treatment empirically for about a month, but the results were ineffective. Finally, the prevotella was detected as the pathogenic bacteria from lavage fluid and blood by metagenomic next generation sequencing (mNGS). ConclusionsThe pathogen Prevotella is opportunistic. The use of mNGS in the etiological identification of complex infections is worthy of further acclaim in clinical practice when infected patients fail to respond to standard empirical treatment.