Severe pneumonia complicated with encapsulated empyema caused by Streptococcus anginosus in a child: a case report and literature review
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摘要: 本文报道咽峡炎链球菌(Streptococcus anginosus，SA)感染致儿童重症肺炎、包裹性脓胸1例并复习相关文献。该患儿以“发热、呼吸急促”为主要表现，胸部CT提示两肺炎症，肺实变伴部分肺不张，两侧包裹性胸腔积液，经及时诊断及早期抗感染联合外科胸腔镜手术治疗，患儿恢复良好，出院后随访2.5个月，患儿肺部病变基本吸收，无后遗症。Abstract: This article reported a case of severe pneumonia and encapsulated empyema in a child caused by streptococcus anginosus infection. The patient was admitted to the hospital with fever and shortness of breath. A computed tomography scan of the chest showed bilateral pneumonia, pulmonary consolidation with partial atelectasis, and bilateral encapsulated pleural effusion. After timely antibiotic therapy combined with video-assisted thoracoscopic surgery, the child had a significant clinical improvement. The patient was followed up for 2.5 months after discharge, he was well. The chest X-ray was normal, and there were no sequelae.
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Key words:
- Severe pneumonia /
- Streptococcus anginosus /
- Empyema /
- Pediatric
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图 1 患儿入院第2天胸部CT影像
注：胸部CT扫描显示两肺炎症，纵隔气肿，右肺少量气胸，两侧胸腔积液。
Figure 1. Chest computed tomography imaging on the second day of admission
图 2 患儿入院第4天胸部CT影像
注：胸部CT扫描显示两肺多发炎症，部分肺实变、肺不张，两侧包裹性胸腔积液。
Figure 2. Chest computed tomography imaging on the 4th day of admission
图 3 患儿胸腔镜术中影像
注：胸腔镜术中图片，可见整个左肺表面为大量黄白色脓苔覆盖，并与胸壁粘连。
Figure 3. The image during video-assisted thoracoscopic surgery
图 4 患儿入院第42天胸部CT影像
注：胸部CT扫描显示两肺炎症较前吸收，两侧胸腔少许积液。
Figure 4. Chest computed tomography imaging on the 42nd day of admission
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[1] KURYLEK A, STASIAK M, KERN-ZDANOWICZ I. Virulence factors of Streptococcus anginosus: a molecular perspective[J]. Front Microbiol, 2022, 13: 1025136. DOI: 10.3389/fmicb.2022.1025136. [2] JIANG S H, LI M, FU T, et al. Clinical characteristics of infections caused by Streptococcus anginosus group[J]. Sci Rep, 2020, 10(1): 9032. DOI: 10.1038/s41598-020-65977-z. [3] 徐涛, 王华英, 俞万钧. 结核病合并星座链球菌感染2例及文献复习[J]. 中华全科医学, 2018, 16(9): 1588-1590. doi: 10.16766/j.cnki.issn.1674-4152.000432XU T, WANG H Y, YU W J. Two cases of tuberculosis complicated with constellation streptococcus infection and literature review[J]. Chinese Journal of General Practice, 2018, 16(9): 1588-1590. doi: 10.16766/j.cnki.issn.1674-4152.000432 [4] FURUICHI M, HORIKOSHI Y. Sites of infection associated with Streptococcus anginosus group among children[J]. J Infect Chemother, 2018, 24(2): 99-102. doi: 10.1016/j.jiac.2017.09.011 [5] ISMAIL K, HUGHES I, MOLONEY S, et al. Streptococcus anginosus group infections in hospitalized children and young people[J]. J Paediatr Child Health, 2022, 58(5): 809-814. doi: 10.1111/jpc.15840 [6] 胡惠丽, 董方, 宁雪, 等. 咽峡炎链球菌群感染患儿119例病例系列报告[J]. 中国循证儿科杂志, 2020, 15(2): 125-129. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK202002008.htmHU H L, DONG F, NING X, et al. Streptococcus anginosus group infectionin 119 children: a case series report[J]. Chinese Journal of Evidence Based Pediatrics, 2020, 15(2): 125-129. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK202002008.htm [7] 李岷, 姜鲁宁, 蒋胜华. 肺咽峡炎链球菌群感染患者的临床特征[J]. 中华医学杂志, 2020, 100(20): 1578-1581.LI M, JIANG L N, JIANG S H. Clinical analysis of chest infections caused by streptococcus anginosus group[J]. National Medical Journal of China, 2020, 100(20): 1578-1581. [8] COBO F, SAMPEDRO A, RODRÍGUEZ-GRANGER J, et al. Clinical and microbiologic characteristics of pleuro-pulmonary infection due to Streptococcus intermedius[J]. Rev Esp Quimioter, 2018, 31(2): 146-151. [9] NOGUCH S, YATERA K, KAWANAMI T. Association between obligatory anaerobes and empyema caused by Streptococcus anginosus group bacteria[J]. Respir Investig, 2021, 59(5): 686-690. doi: 10.1016/j.resinv.2021.04.009 [10] PILARCZYK-ZUREK M, SITKIEWICZ I, KOZIEL J. The clinical view on Streptococcus anginosus group-opportunistic pathogens coming out of hiding[J]. Front Microbiol, 2022, 13: 956677. DOI: 10.3389/fmicb.2022.956677. [11] PATEL I, DOUEDI S, MAKADIA S, et al. Streptococcus anginosus empyema induced by dental abscess: a case report[J]. J Med Cases, 2020, 11(9): 289-291. doi: 10.14740/jmc3547 [12] SUZUKI T, MORIOKA S, NOMOTO H, et al. Disseminated Streptococcus anginosus invasive infection with intracranial subdural abscess formation[J]. J Infect Chemother, 2022, 28(5): 696-698. doi: 10.1016/j.jiac.2021.12.016 [13] ISSA E, SALLOUM T, TOKAJIAN S. From normal flora to brain abscesses: a review of Streptococcus intermedius[J]. Front Microbiol, 2020, 11: 826. doi: 10.3389/fmicb.2020.00826 [14] 李刚, 郭睿, 王文, 等. 2014—2019年咽峡炎链球菌群血流感染临床特点及其耐药性分析[J]. 中国感染与化疗杂志, 2020, 20(5): 476-480. https://www.cnki.com.cn/Article/CJFDTOTAL-KGHL202005006.htmLI G, GUO R, WANG W, et al. Clinical characteristics and antibiotic resistance profiles of Streptococcus anginosus group bloodstream infection from 2014 to 2019[J]. Chinese Journal of Infection and Chemotherapy, 2020, 20(5): 476-480. https://www.cnki.com.cn/Article/CJFDTOTAL-KGHL202005006.htm [15] REIS-MELO A, SOARES D, MAGALHAES M F, et al. Complicated pneumonia with empyema caused by Streptococcus anginosus in a child[J]. Rev Paul Pediatr, 2020, 38: e2018258. DOI: 10.1590/1984-0462/2020/38/2018258. [16] 刘苗, 韩玉玲, 林霞, 等. 儿童星座链球菌感染致多发脓肿1例并文献复习[J]. 临床医药实践, 2022, 31(5): 394-398. https://www.cnki.com.cn/Article/CJFDTOTAL-SXLC202205020.htmLIU M, HAN Y L, LIN X, et al. Multiple abscesses caused by streptococcus infection in a children: a case report and literature review[J]. Proceeding of Clinical Medicine, 2022, 31(5): 394-398. https://www.cnki.com.cn/Article/CJFDTOTAL-SXLC202205020.htm [17] REICHERT M, PÖSENTRUP B, HECKER A, et al. Lung decortication in phase Ⅲ pleural empyema by video-assisted thoracoscopic surgery (VATS)-results of a learning curve study[J]. J Thorac Dis, 2018, 10(7): 4311-4320. doi: 10.21037/jtd.2018.06.72 -
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