■小鹦鹉(P.micra),革兰氏阳性厌氧菌,表现出口腔黏膜和皮肤表面的定植倾向,可能演变成与多种疾病相关的致病实体。P.micra相关疾病的诊断轨迹遇到延误,通常会带来严重后果,包括死亡,归因于缺乏症状特异性和文化挑战。对微囊藻的诊断和治疗方法缺乏共识加剧了解决相关病症的复杂性。本研究旨在阐明和审查与P.micra相关的临床表现,从相关病例报告的广泛文献综述中汲取见解。
■一名53岁的男性因反复咯血在我院就诊。在等待病原体培养结果时开始经验性治疗;然而,病人的症状持续存在。随后的宏基因组下一代测序(mNGS)分析揭示了可归因于P.micra的肺部感染。经哌拉西林舒巴坦钠和盐酸莫西沙星治疗后症状缓解。全面的文献综述,利用PubMed数据库,在过去十年中,我们进行了评估病例报告,其中P.micra被确定为病原体。
■文献分析强调了P.micra对患有心血管疾病的免疫功能低下人群的偏爱,糖尿病,骨科条件,和肿瘤。危险因素,包括口腔和牙周卫生,吸烟,和酒精消费,被发现与P.micra感染有关。临床表现包括发热,咳嗽,痰液生产,和背部疼痛,可能导致严重的结果,如脊椎盘炎,化脓性关节炎,肺脓肿,菌血症,脓毒症,和死亡率。虽然传统的细菌培养仍然是主要的诊断工具,mNGS等新兴技术提供了替代考虑因素。在治疗方式上,β-内酰胺类抗生素和硝基咪唑占优势,回收率分别为56.10%(46/82)和23.17%(19/82),分别。本病例报告和文献综述共同旨在提高临床医生和实验室医学专业人员对P.micra相关感染复杂性的认识。
Parvimonas micra (P. micra), a Gram-positive anaerobic bacterium, exhibits colonization tendencies on oral mucosal and skin surfaces, potentially evolving into a pathogenic entity associated with diverse diseases. The diagnostic trajectory for P. micra-related diseases encounters delays, often with severe consequences, including fatality, attributed to the absence of symptom specificity and challenges in culture. The absence of a consensus on the diagnostic and therapeutic approaches to P. micra exacerbates the complexity of addressing associated conditions. This study aims to elucidate and scrutinize the clinical manifestations linked to P. micra, drawing insights from an extensive literature review of pertinent case reports.
A 53-year-old male sought medical attention at our institution presenting with recurrent hemoptysis. Empirical treatment was initiated while awaiting pathogen culture results; however, the patient\'s symptoms persisted. Subsequent metagenomic next-generation sequencing (mNGS) analysis revealed a pulmonary infection attributable to P. micra. Resolution of symptoms occurred following treatment with piperacillin sulbactam sodium and moxifloxacin hydrochloride. A comprehensive literature review, utilizing the PubMed database, was conducted to assess case reports over the last decade where P. micra was identified as the causative agent.
The literature analysis underscores the predilection of P. micra for immunocompromised populations afflicted by cardiovascular diseases, diabetes, orthopedic conditions, and tumors. Risk factors, including oral and periodontal hygiene, smoking, and alcohol consumption, were found to be associated with P. micra infections. Clinical manifestations encompassed fever, cough, sputum production, and back pain, potentially leading to severe outcomes such as Spondylodiscitis, septic arthritis, lung abscess, bacteremia, sepsis, and mortality. While conventional bacterial culture remains the primary diagnostic tool, emerging technologies like mNGS offer alternative considerations. In terms of treatment modalities, β-lactam antibiotics and nitroimidazoles predominated, exhibiting recovery rates of 56.10% (46/82) and 23.17% (19/82), respectively. This case report and literature review collectively aim to enhance awareness among clinicians and laboratory medicine professionals regarding the intricacies of P. micra-associated infections.