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在使用皮质类固醇治疗骨髓增生异常综合征合并机化性肺炎期间,播散性隐球菌病并发双侧胸腔积液和腹水。

Disseminated cryptococcosis complicated with bilateral pleural effusion and ascites during corticosteroid therapy for organizing pneumonia with myelodysplastic syndrome.

作者信息

Kamiya Hiroyuki, Ishikawa Rie, Moriya Atsuko, Arai Aiko, Morimoto Kozo, Ando Tsunehiro, Ikushima Soichiro, Oritsu Masaru, Takemura Tamiko

机构信息

Japanese Red Cross Medical Center, Tokyo.

出版信息

Intern Med. 2008;47(22):1981-6. doi: 10.2169/internalmedicine.47.0898. Epub 2008 Nov 17.

Abstract

An 83-year-old man with myelodysplastic syndrome was admitted to our hospital due to dyspnea and abnormal shadows on chest X-ray films during corticosteroid therapy for organizing pneumonia. He was diagnosed as having disseminated cryptococcosis with pulmonary lesions after detecting Cryptococcus neoformans. Both bilateral pleural effusion with or without ipsilateral pulmonary lesions and ascites ensued, and it was assumed that both direct involvement and serositis were associated with the fluid accumulation. Cryptococcal yeast was only detected in the right pleural effusion, and the titer of cryptococcal antigen was quite different between body cavities, even though it was positive in all sites.

摘要

一名83岁的骨髓增生异常综合征男性患者,在接受糖皮质激素治疗机化性肺炎期间,因呼吸困难和胸部X线片出现异常阴影而入住我院。在检测到新型隐球菌后,他被诊断为播散性隐球菌病伴肺部病变。随后出现双侧胸腔积液,伴或不伴有同侧肺部病变及腹水,推测积液与直接侵犯和浆膜炎均有关。仅在右侧胸腔积液中检测到隐球菌酵母,尽管所有体腔的隐球菌抗原滴度均为阳性,但各体腔之间的滴度差异很大。

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