Abstract：
Coinfection of Pseudomonas and Aspergillus has not been previously reported in patients with chronic obstructive pulmonary disease (COPD). A middle-aged, thinly built woman (Body Mass Index: 18.1 kg/m²) who smokes bidi (a type of tobacco) and has a history of exposure to open log fires for cooking, has been suffering from COPD for the last 4 years. She has been taking inhaled betamethasone and tiotropium. Additionally, she had uncontrolled diabetes for a few months. She presented with fever, productive cough, shortness of breath and chest pain for 5 days. She required non-invasive ventilation support for type-2 respiratory failure. Chest X-ray and CT confirmed pneumonia, cavities and abscesses in both lungs. Repeated sputum and bronchoalveolar lavage confirmed coinfections with Pseudomonas aeruginosa and Aspergillus fumigatus, respectively. Along with supportive therapy, she was treated with tablet levofloxacin and injection amikacin for 6 weeks based on culture sensitivity reports, and capsule itraconazole for 6 months. She recovered completely to her baseline COPD and diabetes status. This case study confirms that coinfections can occur in COPD and diabetes, highlighting the need for clinicians to be vigilant for the possibility of such symbiotic coinfections.
摘要：
以前在慢性阻塞性肺疾病（COPD）患者中未报道假单胞菌和曲霉的共感染。一个中年人,身材瘦弱的女性（身体质量指数：18.1公斤/平方米）吸烟比迪（一种烟草），并有暴露于明火烹饪的历史，在过去的4年里一直患有COPD。她一直在吸入性倍他米松和噻托溴铵。此外,她有几个月不受控制的糖尿病。她发烧了，生产性咳嗽,气促和胸痛5天。她需要2型呼吸衰竭的无创通气支持。胸部X线和CT证实肺炎,两肺有空洞和脓肿。反复痰和支气管肺泡灌洗证实铜绿假单胞菌和烟曲霉共同感染，分别。除了支持治疗，根据培养敏感性报告，她用左氧氟沙星片剂和阿米卡星注射液治疗6周，和胶囊伊曲康唑6个月。她完全恢复至基线COPD和糖尿病状态。本案例研究证实，合并感染可发生在COPD和糖尿病中，强调临床医生需要警惕这种共生共感染的可能性。
