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After having a high fever and coughing for more than ten days, his lungs turned out to be "moldy"! A 30-year-old man was infected with a rare bacteria
Qilu One Point2024-05-24 10:43
Diao Mingjie reports from Qingdao Correspondent Wang Hao
Recently, Mr. Liu, 30, went to the Qingdao Branch of Peking University People's Hospital for treatment because of high fever and cough for more than ten days. The expert diagnosed that his lungs were "moldy"! In addition to mold infection, he was also infected with the rare "Nocardia". The respiratory and critical care medicine team adjusted the drug treatment in time, and Mr. Liu has been discharged smoothly.
After being admitted to the hospital, Mr. Liu received high-flow oxygen therapy and other treatment measures, but his condition did not improve significantly. Professor Yu Bing, an expert in respiratory and critical care medicine at Peking University People's Hospital and director of the respiratory and critical care medicine department at Peking University People's Hospital Qingdao Hospital, and Zhu Junxiang, deputy chief physician at Peking University People's Hospital Qingdao Hospital, relieved the patient's symptoms while investigating the cause of the disease. They eventually found branched hyphae in the patient's lungs in the patient's imaging, and highly suspected Aspergillus infection.
Aspergillus is a common mold in nature, which may exist in water, soil and air. When the human body's immunity is weakened, inhaling a certain amount of Aspergillus spores will cause infection, which can cause illness when it exceeds the body's defense ability. When the lungs are infected by Aspergillus, symptoms such as coughing, fever and difficulty breathing are likely to occur. Because it is similar to a cold or flu, it is easy to ignore.
Relevant tests confirmed that the patient was infected with Aspergillus. The "real culprit" was found, and the respiratory and critical care medicine team immediately gave symptomatic treatment such as antifungal drugs. Mr. Liu's condition also showed a "turnaround": oxygenation gradually improved, and the symptoms of breath holding were better than before. In the subsequent treatment, Mr. Liu's condition changed again, with severe chest pain and fever. A chest CT scan showed partial consolidation in the lower lobe of the lungs and a cavity shadow. The infection caused severe pneumonia.
"The pathogen may be more than just Aspergillus!" Based on the patient's condition, an expert from the Department of Respiratory and Critical Care Medicine made this judgment.
The medical team immediately performed bronchoscopy and alveolar lavage for the patient to improve symptoms, and quickly performed NGS (next-generation sequencing) on the lavage fluid specimens obtained through bronchoscopy. The results of the patient's specimen test showed that in addition to Aspergillus, there were also Nocardia St. George and influenza B virus.
Nocardia is an opportunistic pathogen, mostly saprophytic, commonly found in soil, decaying plants, dust or water. Nocardia can enter the skin through trauma or enter the human body through the respiratory tract or digestive tract, causing acute or chronic suppurative or granulomatous diseases. Mr. Liu suffered pneumonia due to Nocardia affecting the lungs, with symptoms such as cough, sputum and fever.
As the "real culprits" surfaced one by one, the respiratory and critical care medicine team adjusted the drug treatment in time. Under the careful treatment of medical staff, the patient's chest pain gradually eased, body temperature returned to normal, and symptoms such as dyspnea gradually eased. After a period of treatment, a chest CT scan was performed again, and Mr. Liu's lung lesions were absorbed and improved, and he has now been successfully discharged from the hospital.
Since the symptoms, signs and imaging examinations of Nocardia lack specificity, they are easily overlooked. Professor Yu Bing, director of the Department of Respiratory and Critical Care Medicine at the Qingdao Hospital of Peking University People's Hospital, said that pathogens such as Aspergillus, Nocardia St. George, and influenza B virus will take advantage of the opportunity to enter the human body when the body's resistance is reduced. If the human immune function is low and the infection worsens, it may cause infections of the oral cavity, skin, urinary system, gastrointestinal tract, and even systemic infection. When Mr. Liu, a patient, has multiple infections at the same time, his condition is more complicated, more difficult to treat, and more dangerous.
Experts remind: In summer, there are often some "small black spots" on the sink countertops, bathroom corners, and toilet brick seams at home. These are mold colonies. A humid and warm environment is very prone to mold growth. Pay attention to personal and environmental hygiene, clean regularly, and keep the room ventilated and dry. When cleaning the house, remember to wear a mask to prevent mold from taking advantage of the opportunity to enter.
source: zhttps://baijiahao.baidu.com/s?id=1799900236721961925&wfr=spider&for=pc