肺炎链球菌坏死性肺炎伴WU多瘤病毒感染1例并文献复习

A Case Report of Streptococcus pneumoniae Necrotizing Pneumonia with WU Polyomavirus Coinfection and Literature Review

摘要: 目的：探讨肺炎链球菌坏死性肺炎(SPNP)伴WU多瘤病毒(WU polyomavirus, WUPyV)感染的临床特征、诊断及治疗策略。方法：回顾性分析青岛大学附属医院儿童呼吸心血管内科收治的1例SPNP伴WUPyV感染患儿的临床资料，并结合文献复习总结其诊疗经验。结果：患儿男，3岁10月，因发热、咳嗽8天入院，初始抗生素治疗无效，经胸部CT及高通量测序技术(NGS)确诊为SPNP伴WUPyV感染。予多种抗生素联合抗感染、甲泼尼龙抗炎及胸腔闭式引流治疗后，患儿症状缓解，预后良好。结论：SPNP的临床表现较重但预后良好，SPNP伴WUPyV感染比较罕见，需结合临床表现、影像学及病原学检测结果综合判断。早期诊断和合理治疗对改善预后至关重要。

Abstract: Objective: To explore the clinical features, diagnosis, and treatment strategies of Streptococcus pneumoniae necrotizing pneumonia (SPNP) combined with WU polyomavirus (WUPyV) infection. Methods: A retrospective analysis of the clinical data of a child with SPNP combined with WUPyV infection, treated at the Department of Pediatric Respiratory Cardiovascular of The Affiliated Hospital of Qingdao University, was conducted. The diagnostic and therapeutic experiences were summarized based on the case and a review of the literature. Results: The patient was a 3-year and 10-month-old boy who presented with fever and cough for eight days. Initial antibiotic therapy was ineffective. The diagnosis of SPNP with WUPyV coinfection was confirmed via chest CT and metagenomic next-generation sequencing (NGS). Treatment included combined antibiotic therapy, anti-inflammatory therapy with methylprednisolone, and closed thoracic drainage, leading to symptom resolution and a favorable prognosis. Conclusion: SPNP manifests with severe clinical symptoms but generally has a good prognosis. Diagnosing SPNP with WUPyV coinfection is rare and requires a comprehensive assessment of clinical presentation, imaging findings, and pathogen detection. Early diagnosis and appropriate treatment are crucial for improving outcomes.