Fujita K, Akutgawa S, Ikeda S, Goto I, Fukuda Y, Min K Y, Hanafusa T
Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, Japan.
Nihon Kokyuki Gakkai Zasshi. 2000 Dec;38(12):932-6.
A 38-year-old male with swollen parotid glands was admitted to our hospital with dyspnea on effort. Positive serum IgM antibody for mumps supported a diagnosis of mumps. Computed tomography (CT) scan showed a ground-glass appearance in both lower lungs. On the third day of hospitalization, bronchoalveolar lavage demonstrated an elevation of both the total cell (2.0 x 10(6)/cc) and the lymphocyte count (83%), as well as a decrease of the CD 4+/CD 8+ ratio (0.4). Bronchial biopsy specimens revealed infiltration of lymphocytes in both the bronchiolar walls and the alveolar septa. These data were suggestive of mumps pneumonia. The patients suffered acute respiratory failure on the seventh day of hospitalization, which improved after 3 days of high-dose methyl prednisolone therapy. This is the first report of adult mumps pneumonia in Japan. As a result of the examination of the bronchoalveolar lavage and a bronchial biopsy of viral pneumonia which had been reported in the past, mumps pneumonia was a corresponding opinion to other viral pneumonia.
一名38岁腮腺肿大男性因劳力性呼吸困难入院。血清腮腺炎IgM抗体阳性支持腮腺炎诊断。计算机断层扫描(CT)显示双下肺呈磨玻璃样外观。住院第三天,支气管肺泡灌洗显示总细胞数(2.0×10⁶/cc)和淋巴细胞计数均升高(83%),同时CD4⁺/CD8⁺比值降低(0.4)。支气管活检标本显示细支气管壁和肺泡间隔有淋巴细胞浸润。这些数据提示为腮腺炎肺炎。患者在住院第七天发生急性呼吸衰竭,大剂量甲基泼尼松龙治疗3天后病情改善。这是日本首例成人腮腺炎肺炎报告。根据既往报道的病毒性肺炎支气管肺泡灌洗和支气管活检检查结果,腮腺炎肺炎与其他病毒性肺炎情况相符。