Kohno S, Hatano T, Yamada H, Maesaki S, Yasuoka A, Kaku M, Koga H, Hara K
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Intern Med. 1992 Apr;31(4):540-3. doi: 10.2169/internalmedicine.31.540.
A 63-year-old woman with chronic necrotizing pulmonary aspergillosis complicated by active pulmonary tuberculosis is reported. A small infiltrative shadow appeared, but no definite diagnosis was made. Six years later the shadow was found to have increased in size; chest CT revealed a fungus ball, while a transbronchial lung biopsy revealed aspergillus hyphae. The intrabronchial inoculation of amphotericin B proved ineffective, and a lobectomy was performed. Histopathologic findings showed necrotic granulomas containing aspergillus and some acid-fast bacilli. While the superinfection of healed tuberculous lesions by Mycobacteria or Aspergillus species is well documented, their coexistence is rare.
报道了一名63岁患有慢性坏死性肺曲霉病并合并活动性肺结核的女性。出现了一个小的浸润性阴影，但未明确诊断。六年后，发现该阴影增大；胸部CT显示有一个真菌球，而经支气管肺活检发现有曲霉菌丝。支气管内注射两性霉素B证明无效，遂行肺叶切除术。组织病理学检查结果显示坏死性肉芽肿内含有曲霉菌和一些抗酸杆菌。虽然结核病灶愈合后被分枝杆菌或曲霉菌属二重感染已有充分记录，但它们同时存在的情况很少见。
