A 38-year-old woman presented with a 1-month history of progressive cough and phlegm. She was an office worker. She denied the presence of comorbidities including diabetes, renal disease, malignancy and acquired immune deficiency syndrome. She underwent chest CT scan (figure 1A) 2 weeks before admission, having been taking moxifloxacin treatment for 12 days without improvement in symptoms. A repeat CT scan at admission showed significant progression of the lung lesions compared with previous imaging (figure 1B). Sputum culture was negative. Laboratory investigations revealed NK cells, CD4+, CD8+ lymphocytes and the CD4+/CD8+ lymphocytes ratio, serum interferon-γ, TNF-α, immunoglobulins (IgG, IgA and IgM), and complement components 3 and 4 detections were all in the normal range. A bronchoscopy showed mucoid impactions completely obstructed the anterior basal segment of the right lower lobe (figure 1C). Radial endobronchial ultrasound (EBUS) was used to detect the lesion in the bronchial …

中文翻译：

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长臂木霉引起的侵袭性肺部感染

一名 38 岁的女性因进行性咳嗽和痰多 1 个月就诊。她是一名上班族。她否认存在合并症，包括糖尿病、肾病、恶性肿瘤和获得性免疫缺陷综合征。她在入院前 2 周接受了胸部 CT 扫描（图 1A），服用莫西沙星治疗 12 天后症状无改善。入院时的重复 CT 扫描显示肺部病变与之前的影像学检查相比有显着进展（图 1B）。痰培养阴性。实验室检查显示 NK 细胞、CD4+、CD8+ 淋巴细胞和 CD4+/CD8+ 淋巴细胞比值，血清干扰素-γ、TNF-α、免疫球蛋白（IgG、IgA 和 IgM）以及补体成分 3 和 4 检测均在正常范围内。支气管镜检查显示粘液嵌塞完全阻塞了右下叶的前基底段（图 1C）。径向支气管内超声（EBUS）用于检测支气管中的病变……