Ishizuka Tamotsu, Oyama Tatsuya, Sato Minoru, Hisada Takeshi, Takagi Hitoshi, Hamada Tetsuya, Kimura Takao, Kashiwabara Kenji, Mori Masatomo
First Department of Internal Medicine, Gunma University School of Medicine, Showa-machi, Maebashi, Japan.
Respirology. 2003 Sep;8(3):401-3. doi: 10.1046/j.1440-1843.2003.00476.x.
A 69-year-old man developed an episode of severe community-acquired pneumonia 9 months after resection of aspergilloma. Although Aspergillus fumigatus was also isolated in the pleural cavity, it did not invade the remaining lung parenchyma. The patient developed progressive bilateral pneumonia leading to death from respiratory failure. Burkholderia cepacia was considered as prime pathogen, as it was repeatedly cultured from sputum and tracheal secretions, as well as the autopsy lung. B. cepacia is resistant to most antibiotics, and seldom causes pneumonia in patients without cystic fibrosis or chronic granulomatous disease. The precise reason that this apparently immunocompetent patient developed B. cepacia pneumonia remains unknown.
一名69岁男性在曲霉菌瘤切除术后9个月发生了一次严重的社区获得性肺炎。尽管在胸腔中也分离出了烟曲霉,但它并未侵犯剩余的肺实质。患者出现进行性双侧肺炎,最终因呼吸衰竭死亡。洋葱伯克霍尔德菌被认为是主要病原体,因为它在痰液、气管分泌物以及尸检肺组织中均被反复培养出来。洋葱伯克霍尔德菌对大多数抗生素耐药,并且很少在没有囊性纤维化或慢性肉芽肿病的患者中引起肺炎。这位明显免疫功能正常的患者发生洋葱伯克霍尔德菌肺炎的确切原因仍然不明。