Collection and analysis of the clinical and laboratory data of aspiration pneumonia patients who underwent mNGS detection of pleural effusion at the Second Hospital of Jilin University from November 2020 and March 2022.
Nine males and one female were included, aged 33 to 69 years. All patients had chest pain, fever, cough, and hypoxemia symptoms; 90% had expectoration. The laboratory tests revealed that all patients had elevated white blood cell, neutrophil, and C-reactive protein (CRP) levels. Furthermore, erythrocyte sedimentation rate (ESR) increased in 8 patients, and procalcitonin increased in only one patient. Chest CT indicated different degrees of lobar pneumonia and pleural effusion in all patients, and biochemical results implied exudative effusion according to Light criteria. Most routine culture results were negative. Among bacteria identified by mNGS, Fusobacterium nucleatum (n=9) was the most common, followed by Parvimonas micra (n=7) and Filifactor alocis (n=6). Three patients underwent surgical treatment after applying targeted antibiotics, thoracic puncture and drainage, and fibrinolytic septum treatment. After the adjusted treatment, the number of white blood cells, neutrophils, and lymphocytes decreased significantly, indicating the eradication of the infection.
Improving the vigilance of atypical people suffering from aspiration pneumonia is essential. The mNGS detection of pleural effusion clarified the microbial spectrum of aspiration pneumonia, allowing targeted antibiotic administration.
UNASSIGNED:收集和分析2020年11月至2022年3月在吉林大学第二医院接受mNGS检测胸腔积液的吸入性肺炎患者的临床和实验室数据。
未经授权:包括9名男性和1名女性,33至69岁。所有患者都有胸痛,发烧,咳嗽,和低氧血症症状;90%有咳痰。实验室检查显示所有患者的白细胞升高,中性粒细胞,和C反应蛋白(CRP)水平。此外,8例患者红细胞沉降率(ESR)升高,只有一名患者的降钙素原增加。胸部CT显示所有患者均有不同程度的大叶性肺炎和胸腔积液。生化结果提示根据Light标准有渗出性积液。大多数常规培养结果为阴性。在mNGS鉴定的细菌中,具核梭杆菌(n=9)是最常见的,其次是细小病毒(n=7)和菲律宾因子(n=6)。3例患者应用靶向抗生素后接受手术治疗,胸腔穿刺和引流,和纤溶隔膜治疗。调整后的治疗,白细胞的数量,中性粒细胞,淋巴细胞显著减少,表明感染的根除。
UNASSIGNED:提高患有吸入性肺炎的非典型人群的警惕性至关重要。胸腔积液的mNGS检测明确了吸入性肺炎的微生物谱,允许有针对性的抗生素给药。