Arakaki N, Higa F, Tateyama M, Yamazato Y, Yara S, Ishimine T, Toyama M, Miyara T, Koide M, Saito A
First Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa.
Intern Med. 1999 Feb;38(2):160-3. doi: 10.2169/internalmedicine.38.160.
A 48-year-old woman was admitted to our hospital with high fever, chills, cough, and exertional dyspnea. On admission, the chest roentgenogram and computed tomography scan showed bilateral alveolar infiltration in the middle and lower lung fields. Microscopic examination of the bronchial lavage fluid showed flower cells typical for adult T-cell leukemia (ATL) and cysts of Pneumocystis carinii, and Legionella pneumophila serogroup 1 grew on buffered charcoal yeast extract (BCYE)-alpha agar. The patient was successfully treated with antibiotics including trimethoprim/sulfamethoxazole, erythromycin, and sparfloxacin. Remission of ATL was achieved after three courses of antileukemic chemotherapy. Mixed infection of opportunistic pathogens should be considered in patients with ATL.
一名48岁女性因高热、寒战、咳嗽及劳力性呼吸困难入院。入院时，胸部X线片和计算机断层扫描显示双肺中下野肺泡浸润。支气管灌洗液显微镜检查显示有成人T细胞白血病（ATL）典型的花细胞及卡氏肺孢子虫囊肿，嗜肺军团菌血清1型在缓冲活性炭酵母浸出液（BCYE）-α琼脂上生长。患者接受了包括甲氧苄啶/磺胺甲恶唑、红霉素和司帕沙星在内的抗生素治疗，治疗成功。经过三个疗程的抗白血病化疗后，ATL获得缓解。ATL患者应考虑机会性病原体的混合感染。
