Haranaga Shusaku, Tamayose Maki, Nakamura Hideta, Furugen Makoto, Yara Satomi, Higa Futoshi, Tateyama Masao, Fujita Jiro
Department of Medicine and Therapeutics, Control and Prevention of Infectious Disease, Faculty of Medicine, University of the Ryukus, Okinawa.
Nihon Kokyuki Gakkai Zasshi. 2010 Feb;48(2):128-33.
A 28-year-old woman was admitted to our hospital complaining of a 7-day chilly sensation with fever. She was given a diagnosis of pneumococcal pneumonia because of infiltration on chest radiography, sputum gram staining and testing positive for a pneumococcal urinary antigen. A 10-day course of antibiotics showed improvements in symptoms and infiltration. However, her X-ray film revealed severe volume loss in the right lung. Organizing pneumonia was diagnosed with lymphocytosis in BALF and Masson bodies upon TBLB examination. Administration of prednisolone obtained rapid improvement of the volume loss. This case was interesting, showing an organizing tendency in the acute-stage pneumococcal pneumonia.
一名28岁女性因发热伴寒战7天入院。胸部X线检查有浸润影，痰革兰氏染色及肺炎球菌尿抗原检测呈阳性，诊断为肺炎球菌肺炎。给予10天的抗生素治疗后症状及浸润影有所改善。然而，她的胸部X线片显示右肺严重容积减少。经支气管肺活检（TBLB）检查发现支气管肺泡灌洗液（BALF）中有淋巴细胞增多及马松小体，诊断为机化性肺炎。给予泼尼松龙治疗后，容积减少迅速改善。该病例很有意思，显示了急性肺炎球菌肺炎的机化倾向。
