艾滋病合并惠普尔养障体与耶氏肺孢子菌混合感染1例

AIDS patient infected with Tropheryma whipplei and Pneumocystis jirovecii: One case report

摘要:

惠普尔养障体(TW)是革兰阳性杆菌, 为条件致病菌, 引起的疾病称惠普尔病。TW肺炎是TW感染所致的肺炎, 相对罕见, 且临床症状无特异性, 采用传统病原菌培养法难以检测, 在临床上较易误诊。本文报告一例通过宏基因组二代测序(mNGS)检测确诊并成功救治的TW合并耶氏肺孢子菌感染的人类免疫缺陷病毒(HIV)感染患者重症肺炎病例, 根据mNGS结果不断调整抗菌治疗方案及抗炎治疗, 最终该患者病情好转出院。

Abstract:

Tropheryma whipplei (TW) is Gram-positive bacillus, a kind of opportunistic pathogen, which can cause Whipple's disease. Caused by TW infection, TW pneumonia is relatively rare and lacks specific clinical symptoms. It is difficult to be detected through traditional pathogen culture methods and is prone to be misdiagnosed in clinical practice. This paper reports a case of acquired immunodeficiency syndrome (AIDS) patient with severe pneumonia caused by TW and Pneumocystis jiroveci, confirmed by metagenomic next-generation sequencing (mNGS) and successfully treated. Based on mNGS results, antimicrobial and anti-inflammatory treatments were continuously adjusted, till the patient improved and were ultimately discharged.