深圳市中医院于2025年5月3日收治1例因“乏力气短1月余，加重伴咳嗽咳痰10 d”入院就诊的59岁女性患者。患者长期务农，入院前3个月前曾于餐厅工作，接触生鲜。入院检查示白细胞5.60 × 10⁹/L，中性粒细胞占比89.6%↑，嗜酸粒细胞0.02 × 10⁹/L，血气分析pH为7.438，二氧化碳分压（PCO₂）为35.5 mmHg，氧分压（PO₂）为57 mmHg↓，氧合指数173 mmHg↓。肺功能检查示中重度混合性肺通气功能障碍，支气管舒张试验阳性。胸部CT示双肺弥漫马赛克及磨玻璃样影。痰涂片和气管镜下肺泡灌洗液查见粪类圆线虫，支气管镜肺泡灌洗液靶向测序显示耶氏肺孢子菌序列数为75 545条，血流感染靶向测序肺孢子菌属序列数为276 631条，丰度为99.38%。诊断为肺部粪类圆线虫合并耶氏肺孢子菌感染，予阿苯达唑片（0.4 g/d）及复方磺胺甲噁唑（0.4 g，80 mg/6 h）口服，配合抗炎平喘等治疗后患者病情继续进展，出现呼吸困难加重、胸闷明显等表现，遂于5月9日转至专科医院继续治疗。随访患者外院感染持续加重，予气管插管呼吸机及体外膜肺氧合等治疗。

In May 3, 2025, a 59-year-old female patient was admitted to Shenzhen Traditional Chinese Medicine Hospital with complaints of fatigue and shortness of breath for over one month, worsened with cough and expectoration for 10 days. The case was engaged in agriculture for a long period of time, and worked in a restaurant 3 months prior to admission, with exposure to fresh food. Admission examinations showed a white blood cell count of 5.60 × 10⁹/L, a neutrophils proportion of 89.6%↑, an eosinophil count was 0.02 × 10⁹/L, and blood gas analysis revealed a pH value of 7.438, CO₂ partial pressure (PCO₂) of 35.5 mmHg, O₂ partial pressure (PO₂) of 57 mmHg↓, and oxygenation index of 173 mmHg↓. Pulmonary function tests revealed moderate to severe mixed ventilatory dysfunction with a positive bronchodilation test. Chest CT scans displayed diffuse mosaic and ground-glass opacities in bilateral lungs. Strongyloides stercoralis was found in sputum smears and bronchoalveolar lavage fluid under a bronchoscope. Targeted sequencing of bronchoalveolar lavage fluid under a bronchoscope identified 75 545 sequences of Pneumocystis jirovecii, and targeted sequencing of bloodstream infections identified 276 631 sequences of P. jirovecii, with abundance of 99.38%. The case was diagnosed as S. stercoralis and P. jirovecii co-infection in the lung, and was given oral administration of albendazole (0.4 g/d) and compound sulfamethoxazole tablets (0.4 g, 80 mg/6 h), along with anti-inflammatory and anti-asthmatic therapy. However, the patient’s disease condition continued to progress, with worsening dyspnea and remarkable chest tightness, and the case was promptly transferred to a specialized hospital for further management in May 9. Follow-up revealed that the infection continued to worsen after transfer to another hospital, endotracheal intubation, ventilator and ECMO support were given.