Persistence of Pseudomonas aeruginosa in a pulmonary nodule with late relapse.
Persistence of Pseudomonas aeruginosa in a pulmonary nodule with late relapse.
复制标题
肺结节中铜绿假单胞菌的持续存在，且晚期复发。
DOI：
10.1111/tid.12253
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Danner,RL
中科院分区：
文献类型：
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作者：
Ronkainen,S;Xie,Y;Battiwalla,M;Barrett,AJ;Stock,F;Dekker,JP;Danner,RL
肺结节是造血干细胞移植和实体器官移植中常见的诊断难题。铜绿假单胞菌是这些患者肺脓肿的已知原因，但它在静止的肺结节中持续数月并随后导致复发感染的能力尚不为人所知或文献记载。1例有急性前B细胞淋巴细胞白血病病史的患者在异基因造血干细胞移植10个月后出现右上叶小结节肿大和空洞。该结节是移植后2.5个月发生的推测的P。无菌栓子的残留物。经抗生素治疗后，结节缩小至1厘米，并保持稳定。经胸针吸绿脓杆菌，通过分子分型可与7.5个月前从血液和支气管肺泡灌洗液中获得的分离株区分开来。可归因于以前治疗的铜绿假单胞菌所致的亚厘米肺结节可能含有活生物并导致复发感染。
Lung nodules are common diagnostic challenges in hematopoietic stem cell transplantation and solid organ transplantation.Pseudomonas aeruginosais a known cause of lung abscess in these patients, but its ability to persist for months in a quiescent lung nodule and later cause recurrent infection is not well known or documented. A patient with a history of acute pre‐B‐cell lymphoblastic leukemia had enlargement and cavitation of a small right upper lobe pulmonary nodule 10 months after allogeneic hematopoietic stem cell transplantation. The nodule was the remnant of a presumedP. aeruginosaseptic embolus that occurred 2.5 months after transplantation. With antibiotic treatment, the nodule had shrunk in size to <1 cm and remained stable. Transthoracic needle aspiration grewP. aeruginosaindistinguishable by molecular typing from isolates obtained 7.5 months earlier from blood and bronchoalveolar lavage fluid. Sub‐centimeter pulmonary nodules attributable to previously treatedP. aeruginosamay harbor viable organisms and lead to recrudescent infection.