艾沙康唑联合肺叶切除术成功治疗肺小孢根霉合并曲霉菌混合感染1例
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Successful treatment of mixed pulmonary infection with Rhizopus microspores and Aspergillus using isaconazole combined with lobectomy: one case report
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    摘要:

    本文报告1例肺部小孢根霉合并曲霉混合感染患者的临床特征及诊疗过程。患者既往有2型糖尿病,本次因糖尿病酮症酸中毒合并肺炎入院,临床表现为咳嗽、咳痰伴发热;影像学显示双肺炎性病变(右肺为主)伴局部实变。支气管肺泡灌洗液(BALF)涂片及半乳甘露聚糖抗原检测(GM试验)均为阴性,宏基因组二代测序(mNGS)早期检出小孢根霉及曲霉核酸序列,同时合并肺炎克雷伯菌和新型冠状病毒感染。最终病理确诊为肺毛霉病合并侵袭性肺曲霉病。经艾沙康唑抗真菌治疗联合右肺中下叶切除术,患者获得临床治愈。

    Abstract:

    This paper reports the clinical characteristics as well as diagnosis and treatment processes of a patient with mixed pulmonary infection of Rhizopus microspores and Aspergillus. The patient had history of type 2 diabetes mellitus, and was admitted to the hospital due to diabetes ketoacidosis complicated with pneumonia. Clinical manifestations included cough, expectoration, and fever. Imaging examination showed inflammatory lesions of bila-teral lungs (mainly in the right lung) associated with local consolidation. Bronchoalveolar lavage fluid (BALF) smears and galactomannan antigen test (GM test) were both negative. Nucleic acid sequences of Rhizopus microspores and Aspergillus were detected by metagenomic next-generation sequencing (mNGS) at the early stage, while complicated infection of Klebsiella pneumoniae and COVID-19 were also found. The final pathological diagnosis was pulmonary mucormycosis combined with invasive pulmonary aspergillosis. The patient achieved clinical curing through the combination of isaconazole antifungal treatment and lobectomy of the right middle-lower lobes.

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段圆方,徐采云,潘引鹏,等.艾沙康唑联合肺叶切除术成功治疗肺小孢根霉合并曲霉菌混合感染1例[J]. 中国感染控制杂志,2025,24(6):859-863. DOI:10.12138/j. issn.1671-9638.20257008.
DUAN Yuanfang, XU Caiyun, PAN Yinpeng, et al. Successful treatment of mixed pulmonary infection with Rhizopus microspores and Aspergillus using isaconazole combined with lobectomy: one case report[J]. Chin J Infect Control, 2025,24(6):859-863. DOI:10.12138/j. issn.1671-9638.20257008.

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  • 收稿日期:2024-09-25
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  • 在线发布日期: 2025-06-24
  • 出版日期: 2025-06-28