PDF(Pubmed)
Abstract：
Pleural empyema can lead to significant morbidity and mortality despite chest drainage and antibiotic treatment, necessitating novel and minimally invasive interventions. Fusobacterium nucleatum is an obligate anaerobe found in the human oral and gut microbiota. Advances in sequencing and puncture techniques have made it common to detect anaerobic bacteria in empyema cases. In this report, we describe the case of a 65-year-old man with hypertension who presented with a left-sided encapsulated pleural effusion. Initial fluid analysis using metagenomic next-generation sequencing (mNGS) revealed the presence of Fusobacterium nucleatum and Aspergillus chevalieri. Unfortunately, the patient experienced worsening pleural effusion despite drainage and antimicrobial therapy. Ultimately, successful treatment was achieved through intrapleural metronidazole therapy in conjunction with systemic antibiotics. The present case showed that intrapleural antibiotic therapy is a promising measure for pleural empyema.
摘要：
尽管胸腔引流和抗生素治疗，胸膜脓胸仍可导致显著的发病率和死亡率。需要新颖的微创干预措施。核梭杆菌是在人类口腔和肠道微生物群中发现的一种专性厌氧菌。测序和穿刺技术的进步使在脓胸病例中检测厌氧菌变得普遍。在这份报告中,我们描述了一例65岁的高血压患者,出现左侧包裹性胸腔积液.使用宏基因组下一代测序（mNGS）进行的初始流体分析显示存在核梭杆菌和黑曲霉。不幸的是,尽管引流和抗菌治疗,患者胸腔积液恶化.最终,通过胸膜腔内甲硝唑治疗联合全身抗生素治疗成功.本病例表明，胸膜腔内抗生素治疗是治疗胸膜脓胸的有希望的措施。
