Yokoyama Toshinobu, Sakamoto Teruo, Shida Norihiko, Shimada Toshifumi, Kaku Nobuo, Aizawa Hisamichi, Oizumi Kotaro
First Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.
J Infect Chemother. 2002 Sep;8(3):247-51. doi: 10.1007/s10156-002-0173-y.
We describe a case of bacteremic, leukopenic pneumococcal pneumonia with respiratory failure, accompanied by diabetic ketoacidosis and hypothermia. Pulmonary leukostasis may play a role in the pathogenesis of the acute respiratory distress syndrome (ARDS) in pneumococcal pneumonia. The patient recovered with mechanical ventilation, intravenous antibiotics, pulse-steroid therapy, and continuous hemodiafiltration (CHDF). In particular, administration of steroid and the use of CHDF may improve the status of pulmonary leukostasis in leukopenic pneumococcal infection.
我们描述了一例伴有呼吸衰竭的菌血症性、白细胞减少性肺炎球菌肺炎病例，同时伴有糖尿病酮症酸中毒和体温过低。肺白细胞淤滞可能在肺炎球菌肺炎急性呼吸窘迫综合征（ARDS）的发病机制中起作用。患者通过机械通气、静脉使用抗生素、脉冲类固醇治疗和持续血液透析滤过（CHDF）得以康复。特别是，类固醇的使用和CHDF的应用可能改善白细胞减少性肺炎球菌感染时的肺白细胞淤滞状态。
