Kono Masato, Fujii Masato, Akamatsu Taisuke, Suda Takafumi, Chida Kingo
Department of Internal Medicine, Yaizu General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2008 Apr;46(4):297-301.
A 53-year-old man had received various chemotherapy and steroid treatments for malignant thymoma. He had demonstrated persistent fever since the beginning of January 2006, and chest radiograph showed consolidation in the left middle lung fields. Bacterial pneumonia was suspected, but antibiotics were not effective. He was referred and admitted to our hospital on January 16. Chest radiograph and CT scan on admission showed diffuse ground-glass opacities, consolidation with cavity, and cystic changes. Pneumocystis jiroveci Pneumonia was diagnosed by examination of alveolar lavage. This patient was regarded as immunodeficient because of steroid treatment, low counts of CD4-positive lymphocytes, and the complication of hypogammagloblinemia. We reported this case of a non-HIV patient with atypical images demonstrating Pneumocystis jiroveci pneumonia.
一名53岁男性因恶性胸腺瘤接受了多种化疗和类固醇治疗。自2006年1月起他持续发热,胸部X线片显示左中肺野实变。怀疑为细菌性肺炎,但抗生素治疗无效。1月16日他被转诊至我院并入院。入院时胸部X线片和CT扫描显示弥漫性磨玻璃影、实变伴空洞及囊性改变。经肺泡灌洗检查诊断为耶氏肺孢子菌肺炎。该患者因类固醇治疗、CD4阳性淋巴细胞计数低及低丙种球蛋白血症并发症而被视为免疫缺陷。我们报告了这例非HIV患者出现非典型影像表现的耶氏肺孢子菌肺炎病例。