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目的提高对摩根摩根菌肺部社区获得性感染的认识。方法报道1例2012年7月痰液中培养分离出摩根摩根菌肺部感染患者的临床资料、诊疗经过及随访过程,并进行相关文献复习。以“摩根摩根菌,肺,感染”为检索词,通过万方医学数据库对中文文献进行检索;以“Morganella Morganii,lung abscess,pneumonia/lung”为检索词,通过PubMed数据库进行检索,检索时间截至2012年12月。结果患者女,57岁,因“发热10 d,咳嗽、咳痰、痰中带血3 d”入院。入院前应用阿奇霉素7 d、头孢呋辛及奥硝唑抗感染治疗2 d。肺CT示右肺上叶后段可见近胸膜空洞形成,右肺下叶及左肺上叶前段见多发片状高密度影,左肺下叶可见较大空洞形成。入院后连续3次合格痰培养结果,经菌型鉴定为摩根摩根菌摩根亚种,对舒普深和左氧氟沙星敏感。给予这2种药物治疗5周后,临床症状完全消失。复查肺部CT见病灶明显吸收,出院后门诊随访4个月,病灶仅残留少许条索状阴影。在万方医学数据库仅检索到2篇,1篇肺部感染的病例报道,1篇是关于摩根摩根菌肺炎临床诊治体会。PubMed数据库检索到3篇,1篇是婴儿社区获得性肺部感染,2篇为成人感染个案报道。结论摩根摩根菌是一种条件性致病菌,临床上社区获得性肺部感染病例少见,不同于其他肺炎治疗,疗程较长,预后良好。
Aim To increase awareness of acquired infection in the lungs of Morgan root caused by Morgan. Methods The clinical data, diagnosis, treatment and follow-up of one patient with pulmonary infection of Morganella Morganella isolated from sputum in July 2012 were reported and the related literatures were reviewed. The Chinese literature was searched using the “Morgan, Morganella, lung and infection” search terms, and the Chinese literature was searched through the Wanfang medical database. The search was conducted using the “Morganella Morganii, lung abscess, pneumonia / lung” search term using the PubMed database , Search time as of December 2012. The results of female patients, 57 years old, because of “fever 10d, cough, sputum, sputum bloody 3 d ” admission. Admission azithromycin before 7 d, cefuroxime and ornidazole anti-infection treatment 2 d. Pulmonary CT showed the right upper lobe posterior segment of the formation of near pleural cavities, right lower lobe and left anterior lobe see multiple high-density sheet, left lobe of the lower lobe visible larger cavities. Consecutive three times after admission sputum culture results identified by the genus Morgan Morgan root Morgan genus, Shu Pu deep and levofloxacin sensitive. After giving these 2 drugs for 5 weeks, the clinical symptoms completely disappeared. Review of lung CT see lesions were significantly absorbed, outpatient follow-up 4 months, the lesion remains only a little bar-like shadow. In the Wanfang medical database, only 2 articles were retrieved, 1 case report of pulmonary infection was reported, and 1 article was about clinical diagnosis and treatment of Morga infection in Morgan. Three were found in the PubMed database, one for community-acquired lung infections in infants and two for adult infections. Conclusion Morganella morgani is a kind of opportunistic pathogen. Clinically, there are few cases of community-acquired pulmonary infection, which is different from other pneumonia treatments and has a long course of treatment and a good prognosis.