Maniwa Ko, Tanaka Eisaku, Taguchi Yoshio, Oida Kazukiyo, Inoue Tetsuro, Kato Terufumi, Sakuramoto Minoru, Maeda Yuji, Terada Kunihiko, Aihara Masanori
Department of Respiratory Medicine, Tenri Hospital.
Kansenshogaku Zasshi. 2002 May;76(5):396-9. doi: 10.11150/kansenshogakuzasshi1970.76.396.
We presented a case of pulmonary Rhizops microsporus var. rhizopodiformis infection which developed abruptly during treatment of bronchial asthma by systemic corticosteroids. The patient, an 85 year-old-woman, was given systemic steroid therapy for 15 days. She suddenly became febrile two days after the therapy and was coughing up yellow sputum. Chest X-ray film showed multiple nodules with cavities which became worsened rapidly. A specimen of sputum culture gave a growth of Mucoraceae, which was identified to be Rhizopus microsporus var. rhizopodiformis. She was given amphotericin B and miconazole was added on the basis of MIC value of the strain. Although she improved initially, her clinical course showed neutropenia, pseudomembranous enterocolitis, malnutrition, and then died after about six months. Because the diagnosis of pulmonary mucormycosis is difficult and prognosis is poor, further studies for investigating clinical features would be necessary.
我们报告了一例微小根霉根足形变种肺部感染病例,该感染在系统性糖皮质激素治疗支气管哮喘期间突然发生。患者为一名85岁女性,接受了15天的系统性类固醇治疗。治疗两天后她突然发热,咳出黄色痰液。胸部X线片显示多个有空洞的结节,且迅速恶化。痰培养标本培养出毛霉科真菌,鉴定为微小根霉根足形变种。给予她两性霉素B,并根据菌株的最低抑菌浓度值加用咪康唑。尽管她最初有所好转,但临床过程显示出中性粒细胞减少、假膜性小肠结肠炎、营养不良,约六个月后死亡。由于肺毛霉病的诊断困难且预后不良,有必要进一步研究以调查其临床特征。