2023 年第 3 期 第 18 卷

系统性红斑狼疮合并诺卡菌感染所致肝脓肿1例

A case of liver abscess caused by systemic lupus erythematosus combined with Nocardia infection

作者：田龙龙李国青

英文作者：Tian Longlong Li Guoqing

单位：扬州大学附属医院风湿免疫科，扬州225000 田龙龙为大连医科大学2020级内科学专业在读研究生

英文单位：  Department of Rheumatology and Immunology Affiliated Hospital of Yangzhou University Yangzhou 225000 China Tian Longlong is a Grade 2020 Master of Internal Medicine in Dalian Medical University

关键词：系统性红斑狼疮；诺卡菌感染；肝脓肿

英文关键词：Systemiclupuserythematosus;Nocardiainfection;Liverabscess

• 摘要：

• 系统性红斑狼疮是一种慢性自身免疫性疾病，可影响细胞、体液免疫，导致机体免疫功能紊乱，且患者长期使用激素和免疫抑制剂药物，增加了感染的风险。诺卡菌感染常见于长期使用激素或免疫抑制剂、人类免疫缺陷病毒感染及器官移植术后等免疫缺陷患者，由于其临床表现及影像学检查缺乏特异性且体外培养困难，因此在临床中容易造成误诊及漏诊，给患者带来不良临床结局。本文报道1例系统性红斑狼疮合并诺卡菌感染的患者，旨在通过总结患者的诊疗经过及回顾相关文献，提高临床医师对自身免疫疾病合并诺卡菌感染的认识，减少误诊及漏诊，实现早诊断早治疗，改善患者临床预后。

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, which can affect cellular and humoral immunity, and lead to immune dysfunction. Long-term use of hormones and immunosuppressants increases the risk of infection. Nocardia infection is common in patients with immune deficiency after long-term use of hormones or immunosuppressants, human immunodeficiency virus infection and organ transplantation. Due to its lack of specificity in clinical manifestations and imaging examination, and difficulty in in in vitro culture, it is easy to cause misdiagnosis and missed diagnosis in clinical practice, bringing adverse clinical outcomes to patients. This paper introduces a patient of SLE combined with Nocardia infection, aiming to improve the clinicians′ understanding of autoimmune diseases combined with Nocardia infection, reduce the occurrence of misdiagnosis and missed diagnosis, realize early diagnosis and treatment, and improve the clinical prognosis of patients by summarizing the diagnosis and treatment of the patient and reviewing the relevant literatures.