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中华重症医学电子杂志

中华重症医学电子杂志 ›› 2021, Vol. 07 ›› Issue (03) : 282 -284. doi: 10.3877/cma.j.issn.2096-1537.2021.03.016

病例报告

重度骨髓抑制致导管源性空洞型重症金黄色葡萄球菌肺炎一例
黄匀1, 明静2, 龚晨晨1, 钟剑敏3, 刘旭4, 付建宇3, 毕红英1, 方慧3(), 唐艳3,†(), 刘媛怡3, 王迪芬4   
  1. 1. 550004　贵阳，贵州医科大学临床医学院
    2. 551700　贵州毕节，贵州省毕节市七星关区人民医院ICU
    4. 550004　贵阳，贵州医科大学附属医院重症医学科
  • 收稿日期:2021-04-26 出版日期:2021-08-28
  • 通信作者: 方慧, 唐艳
  • 基金资助:
    国家自然科学青年基金项目(81701958); 吴阶平医学基金会临床科研专项资助基金(320.6750.18001); 国家自然科学基金培育项目(Ⅰ-2020-26)

Severe myelosuppression causescatheter related severe cavitary Staphylococcus aureus pneumonia

Yun Huang1, Jing Ming2, Chenchen Gong1, Xu Liu3, Jianyu Fu4, Hongying Bi3, Hui Fang1, Yan Tang3,†(), Yuanyi Liu3(), Difen Wang3   

  1. 1. Postgraduate of Guizhou Medical University, Guiyang 550004, China
    2. ICU of People's Hospital of Qixingguan District, Bijie 551700, China
    3. Department of Critical Care Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
  • Received:2021-04-26 Published:2021-08-28
  • Corresponding author: Yan Tang, Yuanyi Liu
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黄匀, 明静, 龚晨晨, 钟剑敏, 刘旭, 付建宇, 毕红英, 方慧, 唐艳, 刘媛怡, 王迪芬. 重度骨髓抑制致导管源性空洞型重症金黄色葡萄球菌肺炎一例[J]. 中华重症医学电子杂志, 2021, 07(03): 282-284.

Yun Huang, Jing Ming, Chenchen Gong, Xu Liu, Jianyu Fu, Hongying Bi, Hui Fang, Yan Tang, Yuanyi Liu, Difen Wang. Severe myelosuppression causescatheter related severe cavitary Staphylococcus aureus pneumonia[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(03): 282-284.

导管相关血流感染（CRBSI）是深静脉置管后的并发症，常见致病菌为金黄色葡萄球菌。重度骨髓抑制时因粒细胞缺乏更易诱发血流性感染，导致化脓性肺炎，若合并脓毒症休克则更为复杂危重。今报道1例重度骨髓抑制致导管源性空洞型重症金黄色葡萄球菌肺炎，以期为类似疾病的成功诊治提供经验。

关键词: 骨髓抑制, 脓毒症休克, 导管相关血流感染, 金黄色葡萄球菌肺炎

Catheter-related bloodstream infection (CRBSI) is a complication of deep venous catheterization,in which Staphylococcus aureus is one of the common pathogens. Agranulocytosis due to severe bone marrow suppression is more likely to induce bloodstream infection and cause purulent pneumonia. When combined with septic shock, they are more complicated and critical. We here report a case of catheter related severe cavitary Staphylococcus aureus pneumonia due to severe myelosuppression, which can provide experience for the successful diagnosis and treatment of similar diseases.

Key words: Bone marrow suppression, Septic shock, Catheter-related bloodstream infection, Staphylococcus aureus pneumonia
图1 深静脉置管患者右颈内静脉穿刺点（D0）
图2 深静脉置管患者不同治疗时间胸部CT检查。图a为治疗中期（第8天），左上肺外侧结节，箭头为空洞形成并见液平面；图b为治疗中期（第8天），左肺中部近背侧结节，箭头为空洞形成并见液平面；图c为治疗后期（第28天），左上肺外侧结节经治疗后，箭头显示范围较前缩小；图d为治疗后期（第28天），左肺中部近背侧结节治疗后，箭头显示范围较前缩小
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