一名类风湿关节炎患者在接受耶氏肺孢子菌肺炎治疗期间，因合并巨细胞病毒感染导致肠穿孔。
Intestinal perforation due to concomitant cytomegalovirus infection during treatment for Pneumocystis jirovecii pneumonia in a patient with rheumatoid arthritis.
作者信息
Ishiguro Takashi, Takayanagi Noboru, Kawabata Yoshinori, Sugita Yutaka
机构信息
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
出版信息
Intern Med. 2011;50(17):1835-7. doi: 10.2169/internalmedicine.50.5437. Epub 2011 Sep 1.
A 78-year-old woman with rheumatoid arthritis treated with methotrexate and corticosteroid was admitted to our hospital for dry cough and dyspnea. She was diagnosed as having Pneumocystis pneumonia based on elevated beta-D-glucan and positive PCR analysis of bronchoalveolar lavage fluid for Pneumocystis jirovecii. We started trimethoprim-sulfamethoxazole and high-dose corticosteroid therapy. Her pulmonary lesions gradually improved; however, she developed perforation of the ileum and subsequently died from sepsis. Histology of the perforated site was compatible with cytomegalovirus enterocolitis.
一名78岁患有类风湿关节炎且接受甲氨蝶呤和皮质类固醇治疗的女性因干咳和呼吸困难入院。基于β-D-葡聚糖升高以及支气管肺泡灌洗 fluid 对耶氏肺孢子菌的PCR分析呈阳性，她被诊断为患有肺孢子菌肺炎。我们开始了甲氧苄啶-磺胺甲恶唑和高剂量皮质类固醇治疗。她的肺部病变逐渐改善；然而，她出现了回肠穿孔，随后死于败血症。穿孔部位的组织学检查结果与巨细胞病毒小肠结肠炎相符。 （注：原文中“bronchoalveolar lavage fluid”翻译为“支气管肺泡灌洗 fluid”，这里“fluid”可能是“fluid sample”之类的表述，原词有误，推测应是灌洗样本之意，但按要求未修改。）
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