菌血症性和白细胞减少性肺炎球菌肺炎：抗生素、脉冲式类固醇及连续性血液透析滤过治疗成功

Bacteremic and leukopenic pneumococcal pneumonia: successful treatment with antibiotics, pulse steroid, and continuous hemodiafiltration.

作者信息

Yokoyama Toshinobu, Sakamoto Teruo, Shida Norihiko, Shimada Toshifumi, Kaku Nobuo, Aizawa Hisamichi, Oizumi Kotaro

机构信息

First Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.

出版信息

J Infect Chemother. 2002 Sep;8(3):247-51. doi: 10.1007/s10156-002-0173-y.

DOI:10.1007/s10156-002-0173-y

PMID:12373489

Abstract

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.

摘要

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。