摘要
惠普尔养障体(Tropheryma Whipple,TW)是一种革兰阳性杆菌,属于苛养菌,临床诊断困难。惠普尔病(Whipple's disease,WD)是由TW感染引起的多系统慢性疾病,其临床表现为咳嗽、胸痛、呼吸困难、咳痰、关节痛和腹痛等。本文报道的病例表现为咳嗽、咳痰、呼吸困难,影像学提示肺脓肿伴胸腔积液,支气管肺泡灌洗液宏基因组学测序为TW感染,予以美罗培南联合复方磺胺甲噁唑(coSMZ)抗感染,治疗期间对coSMZ进行治疗药物监测。经治疗,患者好转出院。本文就该例TW肺炎病例进行报告,治疗过程中及时监测coSMZ血药浓度,旨在为临床诊治TW感染提供依据。
Tropheryma Whipple(TW)is a Gram-positive bacillus that belongs to the fastidious bacteria and difficult to diagnose clinically.Whipple's disease(WD)is a chronic multi-system disease caused by TW infection with clinical manifestations such as cough,chest pain,dyspnea,sputum,arthralgia and abdominal pain.The case reported in this article presented with cough,sputum and dyspnea.Imaging suggested lung abscess with pleural effusion,and metagenomic sequencing of bronchoalveolar lavage fluid indicated TW infection.The patient was treated with meropenem combined with cotrimoxazole(coSMZ)for anti infection,and the therapeutic drug monitoring of coSMZ was conducted during the treatment period.After treatment,the patient was discharged from the hospital.In this article,we report this case of TW pneumonia,and timely monitor the blood concentration of coSMZ during the treatment process,to provide a basis for clinical diagnosis and treatment of TW infection.
作者
俞慧敏
朱婷婷
高春梅
Yu Huimin;Zhu Tingting;Gao Chunmei(Department of Clinical Pharmacy,General Hospital of Eastern Theater Command of the PLA,Nanjing 210002,China;Department of Clinical Pharmacy,Jurong People's Hospital,Zhenjiang 212400,China)
出处
《实用药物与临床》
CAS
2024年第12期912-916,共5页
Practical Pharmacy and Clinical Remedies
基金
句容市科技项目(ZA42212)。
关键词
惠普尔养障体
肺炎
宏基因组二代测序
治疗药物监测
Tropheryma Whipple
Pneumonia
Macrogenomic next-generation sequencing
Therapeutic drug monitoring
作者简介
通信作者:高春梅。
