Liote H, Porte J M, Postal M J, Martin de Lassalle E, Derenne J P
Service de Pneumologie et Réanimation Respiratoire, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Rev Mal Respir. 1990;7(6):603-7.
A 39 year old man who was HIV positive and was treated with trimethoprim-sulfamethoxazole for pneumocystis with hypoxaemia. During the acute episode he had a persistent fever of 38 degrees and hypoxaemia with a PaO2 of 65 mm/Hg and bilateral opacities both radiologically and on a CT scan, which were of alveolar type, with bronchograms identical to those observed before the treatment of the pneumocystis. In view of the negative evidence for a respiratory or extra respiratory infection, a surgical biopsy was performed and this revealed lesions of bronchiolitis obliterans with an organising pneumonia (BOOP). After the thoracotomy, there was a spontaneous clinical cure in a few days and radiological clearance in a month. This very rare diagnosis should be added to the list of causes of alveolar pneumopathy with infiltration and fever occurring during the course of an HIV infection.
一名39岁的男性，HIV阳性，因肺孢子菌肺炎伴低氧血症接受甲氧苄啶-磺胺甲恶唑治疗。在急性期，他持续发热至38度，伴有低氧血症，动脉血氧分压（PaO2）为65mmHg，胸部X线和CT扫描均显示双侧肺部有肺泡型实变影，支气管造影显示与肺孢子菌肺炎治疗前所见相同。鉴于无呼吸道或呼吸道外感染的证据，遂进行了外科活检，结果显示为闭塞性细支气管炎伴机化性肺炎（BOOP）。开胸术后，数天内临床症状自发缓解，一个月后影像学表现消退。这种非常罕见的诊断应列入HIV感染过程中出现的伴有浸润和发热的肺泡性肺病的病因清单中。
