Pharmaceutical care for a rare case of diffuse pulmonary microabscesses complicated with organizing pneumonia

CAI Shuangshuang; QIU Xuewen; LIAO Yue; ZHAO Hongxia; JIANG Hao

doi:10.6039/j.issn.1001-0408.2026.10.20

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Pharmaceutical care for a rare case of diffuse pulmonary microabscesses complicated with organizing pneumonia

更新时间：2026-05-26

- Pharmaceutical care for a rare case of diffuse pulmonary microabscesses complicated with organizing pneumonia
- ZHONGGUO YAOFANG Vol. 37, Issue 10, Pages: 1352-1356(2026)
- 作者机构：
  
  1.重庆市人民医院（重庆大学附属人民医院）药学部，重庆　401147
  2.重庆市医学科学院，重庆　401147
  3.陆军军医大学第一附属医院药学部，重庆　400038
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2026.10.20
  CLC： R978.1;R563;R969
- Received：09 December 2025，
  
  Revised：2026-04-15，
  
  Accepted：16 April 2026，
  
  Published：30 May 2026
- 稿件说明：
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蔡双霜,邱学文,廖钥,等.1例罕见弥散性肺微脓肿合并机化性肺炎的药学监护 ^Δ[J].中国药房,2026,37(10):1352-1356. DOI: 10.6039/j.issn.1001-0408.2026.10.20.

CAI Shuangshuang,QIU Xuewen,LIAO Yue,et al.Pharmaceutical care for a rare case of diffuse pulmonary microabscesses complicated with organizing pneumonia[J].ZHONGGUO YAOFANG,2026,37(10):1352-1356.
蔡双霜,邱学文,廖钥,等.1例罕见弥散性肺微脓肿合并机化性肺炎的药学监护 ^Δ[J].中国药房,2026,37(10):1352-1356. DOI: 10.6039/j.issn.1001-0408.2026.10.20. DOI：

CAI Shuangshuang,QIU Xuewen,LIAO Yue,et al.Pharmaceutical care for a rare case of diffuse pulmonary microabscesses complicated with organizing pneumonia[J].ZHONGGUO YAOFANG,2026,37(10):1352-1356. DOI： 10.6039/j.issn.1001-0408.2026.10.20.

摘要

目的

探讨临床药师在非免疫缺陷患者因星座链球菌所致罕见弥散性肺微脓肿合并机化性肺炎（OP）个体化治疗中的作用。

方法

针对1例中年、无免疫缺陷，且病程长达1年、影像学呈现弥散性微脓肿与OP双重病理特征并存的星座链球菌致肺脓肿患者，临床药师基于药动学/药效学特点，协助临床医生将既往疗效不佳的抗感染方案优化为注射用头孢曲松钠联合甲硝唑氯化钠注射液，以增强用药方案对混合厌氧菌的覆盖及病灶穿透能力；待患者咯血停止后，临床药师建议适时启动小剂量注射用甲泼尼龙琥珀酸钠干预OP；出院后序贯予口服利奈唑胺片、甲硝唑片、甲泼尼龙片、奥美拉唑肠溶片治疗。

结果

实施个体化治疗方案后，患者咯血症状消失，肺部病灶显著吸收，病情稳定出院；出院后3个月随访病情稳定。

结论

对于非免疫缺陷宿主的慢性迁延性肺部感染合并OP，临床药师通过协助临床医生优化抗感染方案，并建议在感染控制后适时启动抗炎治疗，有助于实现良好转归。此类复杂病例的个体化治疗需兼顾病原体覆盖、病理屏障及抗炎时机。

Abstract

OBJECTIVE

To investigate the role of clinical pharmacists in the individualized treatment of a rare case of diffuse pulmonary microabscesses caused by

Streptococcus constellatus

complicated with organizing pneumonia （OP） in a non-immunocompromised patient.

METHODS

For a middle-aged， non-immunocompromised patient with a one-year disease course， whose imaging findings showed the coexistence of diffuse microabscesses and OP caused by

S. constellatus

pulmonary abscess， the clinical pharmacist， based on pharmacokinetics/pharmacodynamics characteristics， assisted the physician in optimizing the previously ineffective anti-infective regimen to Ceftriaxone sodium for injection combined with Metronidazole and sodium chloride injection， so as to enhance coverage of mixed anaerobes and lesion penetration. After the patient’s hemoptysis ceased， the clinical pharmacist recommended timely initiation of low-dose Methylprednisolone sodium succinate for injection to manage OP. Upon discharge， sequential oral therapy with Linezolid tablets， Metronidazole tablets， Methylprednisolone tablets and Omeprazole enteric-coated tablets was prescribed.

RESULTS

After implementation of the individualized treatment regimen， the patient’s hemoptysis resolved， pulmonary lesions significantly regressed， and the patient was discharged in a stable condition. At the three-month follow-up， the patient remained stable.

CONCLUSIONS

For chronic persistent pulmonary infection complicated with OP in a non-immunocompromised host， clinical pharmacists assist clinicians in optimizing anti-infective regimens and recommend the timely initiation of anti-inflammatory therapy after infection control， thereby contributing to favorable clinical outcomes. Individualized treatment of such complex cases requires comprehensive consideration of pathogen coverage， pathological barriers， and the timing of anti-inflammatory intervention.

关键词

Keywords

references

ZHU Y M ， JIANG J ， JIANG T ， et al . Clinical characteristics of lung abscess caused by Streptococcus constellatus infection [J/OL ] . Clin Lab ， 2024 ， 70 （ 7 ）[ 2025-10-10 ] . https：//pubmed.ncbi.nlm.nih.gov/38965969/ https://pubmed.ncbi.nlm.nih.gov/38965969/ . DOI： 10.7754/Clin.Lab.2024.240329 http://dx.doi.org/10.7754/Clin.Lab.2024.240329 .

Jr KING T E ， LEE J S . Cryptogenic organizing pneumonia [J ] . N Engl J Med ， 2022 ， 386 （ 11 ）： 1058 - 1069 .

YOUSEF L ， YOUSEF A ， AL-SHAMRANI A . Lung abscess case series and review of the literature [J ] . Children ， 2022 ， 9 （ 7 ）： 1047 .

KOBO O ， NIKOLA S ， GEFFEN Y ， et al . The pyogenic potential of the different Streptococcus anginosus group bacterial species：retrospective cohort study [J ] . Epidemiol Infect ， 2017 ， 145 （ 14 ）： 3065 - 3069 .

NOGUCHI S ， YATERA K ， KAWANAMI T ， et al . The clinical features of respiratory infections caused by the Streptococcus anginosus group [J ] . BMC Pulm Med ， 2015 ， 15 （ 1 ）： 133 .

GOSSLING J . Occurrence and pathogenicity of the Streptococcus milleri group [J ] . Rev Infect Dis ， 1988 ， 10 （ 2 ）： 257 - 285 .

ACUÑA-ROCHA V D ， LÓPEZ-ZAMARRÓN J C ， RAMÍREZ-VÁZQUEZ J A ， et al . Challenging diagnosis of Streptococcus intermedius -associated empyema in an immunocompetent adult：a case report and literature review [J ] . Cureus ， 2024 ， 16 （ 5 ）： e60482 .

中国医药教育协会感染疾病专业委员会 . 抗菌药物药代动力学/药效学理论临床应用专家共识 [J ] . 中华结核和呼吸杂志， 2018 ， 41 （ 6 ）： 409 - 446 .

HUANG H ， WANG Y X ， JIANG C G ， et al . Intrapulmonary concentration of levofloxacin in patients with idiopathic pulmonary fibrosis [J ] . Pulm Pharmacol Ther ， 2014 ， 28 （ 1 ）： 49 - 52 .

BARTLETT J G . The role of anaerobic bacteria in lung abscess [J ] . Clin Infect Dis ， 2005 ， 40 （ 7 ）： 923 - 925 .

YAMAMOTO N ， FUJITA J ， SHINZATO T ， et al . In vitro activity of sitafloxacin compared with several fluoroquinolones against Streptococcus anginosus and Streptococcus constellatus [J ] . Int J Antimicrob Agents ， 2006 ， 27 （ 2 ）： 171 - 173 .

KANEKO A ， SASAKI J ， SHIMADZU M ， et al . Comparison of gyrA and parC mutations and resistance levels among fluoroquinolone-resistant isolates and laboratory-derived mutants of oral streptococci [J ] . J Antimicrob Chemother ， 2000 ， 45 （ 6 ）： 771 - 775 .

何彦侠，李秀业，熊鑫，等 . 感染后机化性肺炎临床诊断及治疗分析 [J ] . 疑难病杂志， 2019 ， 18 （ 2 ）： 151 - 154 .

SU Z Q ， RAO W Y ， PAN X Y ， et al . Multiple lung cavity lesions，thoracic wall abscess and vertebral destruction caused by Streptococcus constellatus infection：a case report [J ] . Infect Drug Resist ， 2023 ， 16 ： 5329 - 5333 .

JUST H M ， FRANK U ， SIMON A ， et al . Concentrations of ceftriaxone in serum and lung tissue [J ] . Chemotherapy ， 1984 ， 30 （ 2 ）： 81 - 83 .

RUBINSTEIN E ， PRITSCH M ， MARK Z ， et al . Efficacy of ceftriaxone and gentamicin in an abscess model [J ] . Eur J Clin Microbiol ， 1982 ， 1 （ 5 ）： 272 - 277 .

桑梦鸿，张淑艳，张素琴 . 儿童感染后继发性机化性肺炎的诊断与治疗 [J ] . 山东医药， 2025 ， 65 （ 4 ）： 10 - 15 .

RADZIKOWSKA E ， FIJOLEK J . Update on cryptogenic organizing pneumonia [J ] . Front Med ， 2023 ， 10 ： 1146782 .

KRUPAR R ， KÜMPERS C ， HAENEL A ， et al . Kryptogen organisierende pneumonie versus sekundäre organisie-rende pneumonie [J ] . Pathologe ， 2021 ， 42 （ 1 ）： 55 - 63 .

国家卫生健康委员会 . 质子泵抑制剂临床应用指导原则：2020年版 [J ] . 中国实用乡村医生杂志， 2021 ， 28 （ 1 ）： 1 - 9 .

SARALAYA D ， PECKHAM D G ， HULME B ， et al . Serum and sputum concentrations following the oral admi-nistration of linezolid in adult patients with cystic fibrosis [J ] . J Antimicrob Chemother ， 2004 ， 53 （ 2 ）： 325 - 328 .

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