Kinoshita M, Kawaguchi S, Higuchi E, Ichikawa Y, Oizumi K
First Department of Internal Medicine, Kurume University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 May;30(5):959-63.
A 35-year-old man had been exposed to the vapor of dimethyl sulfate which was split over the bed of a truck from an accidentally broken container. After receiving treatment at the critical care unit of our university hospital for respiratory failure, he was transferred to our ward with dyspnea persisting for one month. Chest X-ray showed diffuse nodular and infiltrative shadows and shadows suggestive of bronchial wall thickening. Bronchoscopy demonstrated tracheobronchial stenosis due to severe inflammation, and transbronchial lung biopsy revealed erosion and granulation in tissues of the bronchiolar walls. These findings suggested extensive inflammatory involvement of the respiratory tract extending from the trachea to the bronchioles. Treatment with antibiotics, especially agents with antipseudomonal activity, was effective against secondary pneumonia. Administration of corticosteroid for stenotic lesions of the airway was extremely beneficial. The clinical course of the respiratory lesion caused by dimethyl sulfate intoxication was following, including the bronchoscopic findings. The efficacy of treatment with corticosteroid and antibiotics was evaluated by successive bronchoscopic examinations of the lesions.
一名35岁男性因一个容器意外破裂，接触到洒落在卡车车厢内的硫酸二甲酯蒸汽。在我校医院重症监护室接受呼吸衰竭治疗后，他因持续一个月的呼吸困难被转入我们的病房。胸部X光显示弥漫性结节状和浸润性阴影以及提示支气管壁增厚的阴影。支气管镜检查显示因严重炎症导致气管支气管狭窄，经支气管肺活检显示细支气管壁组织有糜烂和肉芽形成。这些发现提示呼吸道从气管到细支气管存在广泛的炎症累及。使用抗生素治疗，尤其是具有抗假单胞菌活性的药物，对继发性肺炎有效。对气道狭窄病变使用皮质类固醇极为有益。硫酸二甲酯中毒引起的呼吸道病变的临床过程如下，包括支气管镜检查结果。通过对病变进行连续支气管镜检查评估皮质类固醇和抗生素治疗的疗效。
