儿科药学杂志2025，Vol.31Issue(4)：34-39,6.DOI:10.13407/j.cnki.jpp.1672-108X.2025.04.008
1例婴幼儿脓肿分枝杆菌复合群肺病报道并文献复习
Mycobacterium Abscessus Complex Pulmonary Disease in an Infant:a Case Report and Literature Review
摘要
Abstract
Objective:To explore the clinical features,diagnosis and treatment of Mycobacterium abscessus complex(MABC)infection in infants,so as to deepen the laboratory and clinical understanding of the disease.Methods:Clinical diagnosis and treatment of an infant with MABC pulmonary disease were analyzed.Relevant literature from domestic and international databases were retrieved to analyze the clinical characteristics,laboratory diagnosis,treatment options,and prognosis of the disease.Results:A 3 months and 17 days male patient was admitted with clinical manifestations of fever and recurrent cough.Imaging suggested pulmonary mass-like lesions with cavities and associated necrosis.Both the acid-fast staining results and cultures of bronchoalveolar lavage fluid were positive.Targeted next-generation sequencing(tNGS)of various pathogens in the bronchoalveolar lavage fluid,along with MALDI-TOF mass spectrometry(MS),indicated the diagnosis of MABC.After two months of combination treatment including imipenem and cilastatin sodium,sulfamethoxazole,azithromycin,and cefoxitin,the respiratory symptoms were improved,pulmonary lesions showed notable improvement,and both the acid-fast staining smear and culture results for bronchoalveolar lavage fluid were negative.The treatment was effective,and the infant had no recurrence during follow-up after discharge.A total of 20 eligible literature(23 cases)were retrieved,and 24 children(including this case)with MABC were enrolled.Pulmonary infection was the most common type of infection,with pulmonary lesions mainly characterized by inflammatory exudate,nodules,and consolidation.The primary clinical manifestations were fever and cough.There were differences in the treatment regimens,yet most of them were drug combination.Conclusion:There are limited reports on pulmonary disease in infants induced by MABC.The clinical manifestations are lack of specificity,making it prone to misdiagnosis.Traditional etiological tests such as acid-fast staining results and cultures are still the main means of examination,tNGS detection is helpful for rapid clinical diagnosis,multi-disciplinary collaborative diagnosis and treatment combined with multi-drug treatment program have shown significant efficacy and high cure rates.关键词
脓肿分枝杆菌复合群/婴幼儿/肺病Key words
Mycobacterium abscess complex/infants/pneumonia分类
药学引用本文复制引用
梁嘉慧,王双杰,李林霖,刘敏雪,张欢,陈洁琳..1例婴幼儿脓肿分枝杆菌复合群肺病报道并文献复习[J].儿科药学杂志,2025,31(4):34-39,6.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题,编号Z-A20220288、Z20200641. （）
