维罗纳气单胞菌致重症肺炎一例并文献复习

目的 提高对维罗纳气单胞菌导致重症肺炎的认识.方法 分析天津市海河医院呼吸科收治的1例维罗纳气单胞菌致重症肺炎患者的临床资料并结合文献对本病的临床表现、实验室检查、影像学、诊断和治疗进行回顾分析.结果 患者为男性,46岁,无职业.因"发热伴咳嗽、咳痰、气短3 d"于2007年2月5日入院.患者临床表现为突发高热伴咳嗽、咳痰、气短,出现急性呼吸窘迫伴感染性休克,影像学检查示双肺浸润影进展迅速,表现为问质性肺炎.入院后行机械通气改善氧合状态及抗休克治疗,并经支气管镜防污染毛刷吸取下呼吸道分泌物,细菌培养为维罗纳气单胞菌.气管镜下取肺活检,病理显示间质性炎症,经抗生素联合糖皮质激素治疗后症状缓解,肺部浸润影基本吸收.结论 维罗纳气单胞菌可导致重症肺炎,并出现肺间质改变.维罗纳气单胞菌虽属肠道致病菌,但可引起严重的呼吸道感染,常被低估,临床医生对该菌认识不足.

Severe pneumonia caused by Aeromonas veronii biovar sobria: a case report and review of the literature

objective To describe the clinical features of severe pneumonitis with Aeromonas veronii biovar sobria.Method Case report and review of the related literatures.The clinical symptoms,laboratory tests,radiographic patterns,diagnosis,and therapeutic management of a case of severe pneumonia caused by A.veronii biovar sobria were described.Results The clinical symptoms of this patient included cough and sputum production with high fever,followed by acute respiratory distress symptom associated with septic shock.Progressive infiltration of lungs was evident in chest radiography,changes suggestive of interstitial pneumonia.Oxygenation Was improved by mechanical ventilation and anti-shock therapy was administered.A.veronii biovar sobria was grown in three consecutive cultures of airway secretions by fiberoptic bronchoscopy.Mild interstitial inflammation was revealed by pathology of transbronchial lung biopsy specimens.The clinical symptoms and the chest infiltrates improved significantly after therapywith antibiotics and glucocorticoids.Conclusions A.veronii biovar sobria,anintestinal bacterial pathogen,Can cause severe pneumonia,which is often underestimated and inadequately understood.Appropriate antibiotics,glucocorticoids and nutritional support are effective treatments.