迈氏放线菌脓胸：一例报告

Actinomyces meyeri Empyema: A Case Report

摘要: 人类放线菌病是一种由放线菌引起的慢性感染性疾病，衣氏放线菌(Actinomyces israelii)被认为是最早以及最常见的人类放线菌病的病原体，迈氏放线菌(Actinomyces meyeri)是引起人类放线菌病的一种不常见病原体。本文报告一例由迈氏放线菌引起的脓胸。患者为一名71岁的男性，因右侧胸痛伴呼吸困难1月入院，门诊胸部CT示右肺多发炎症；右肺包裹性积液；右侧胸膜增厚，考虑胸膜炎；右侧胸腔少量积液。入院后完善胸腔穿刺置管引流术，引流出脓性胸水，胸水厌氧培养物分离出迈氏放线菌。经静脉注射“哌拉西林钠他唑巴坦钠”(每8小时静脉滴注4.5 g) 19天后症状好转，出院后继续口服“阿莫西林克拉维酸钾片”(每日三次口服0.375 g) 1个半月，随访显示患者症状和影像学明显好转，未再复发。

Abstract: Human actinomycosis is a chronic infectious disease caused by actinomycetes. Actinomyces israelii is regarded as the earliest and most common pathogen of human actinomycosis, while Actinomyces meyeri is an uncommon pathogen causing human actinomycosis. This article reports a case of empyema caused by Actinomyces meyeri. The patient was a 71-year-old male who was admitted to the hospital due to right chest pain accompanied by dyspnea for one month. The outpatient chest CT showed multiple inflammations in the right lung, encapsulated effusion in the right lung, thickening of the right pleura suggests pleurisy and there is a small amount of effusion in the right thoracic cavity. The thoracic puncture and catheterization drainage surgery was improved to drain out purulent pleural effusion, and Actinomyces meyeri was isolated from the anaerobic culture of pleural effusion. After intravenous injection of “Piperacillin Sodium and Tazobactam Sodium” (4.5 g intravenously every 8 hours) for 19 days, the symptoms improved. After discharge, the patient continued to take “Amoxicillin and Clavulanate Potassium Tablets” orally (0.375 g orally three times a day) for one and a half months. The follow-up showed that the patient’s symptoms and imaging improved significantly, and there was no recurrence.