Hospital Estadual Infantil Nossa Senhora da Glória, Vitória, Espírito Santo, Brazil.
Braz J Infect Dis. 2012 May-Jun;16(3):289-93.
Acute cor pulmonale is a clinical syndrome with signs of right-sided heart failure resulting from sudden increase of pulmonary vascular resistance.
A five-year-old male, infected by human immunodeficiency virus (HIV), was admitted at the division of infectious diseases of this hospital with cough, tachydyspnea, fever, and breathing difficulty. Computed tomography scan showed ground-glass opacities, cystic lesions, and bronchiectasis. The patient had nasal flaring, intercostal and subcostal retractions, and keeled chest. Abdomen was depressible; liver was 3 cm from the right-costal border, while spleen was 6 cm from the left-costal border. Echocardiogram examinations showed signs of acute cor pulmonale characterized by pulmonary hypertension and increased right-heart chamber dimensions. DIAGNOSTICS OUTCOME: Acquired immunodeficiency syndrome (AIDS)-B3, lymphocytic interstitial pneumonia (LIP), and acute cor pulmonale. Regressions of pulmonary hypertension and of right-heart chamber were observed after 30 days of highly active antiretroviral therapy (HAART) and chloroquine therapy.
AIDS should be considered in children with recurrent pneumonia that is mostly associated with LIP rather than cystic fibrosis.
急性肺心病是一种临床综合征，其特征为右心衰竭的征象，由肺血管阻力的突然增加引起。
一名五岁的男性，感染了人类免疫缺陷病毒（HIV），因咳嗽、呼吸急促、发热和呼吸困难而入住本院传染病科。计算机断层扫描显示磨玻璃影、囊状病变和支气管扩张。患者出现鼻翼扇动、肋间隙和肋下凹陷，以及鸡胸。腹部可凹陷；肝脏距右肋缘 3 厘米，脾脏距左肋缘 6 厘米。超声心动图检查显示急性肺心病的征象，表现为肺动脉高压和右心腔增大。
获得性免疫缺陷综合征（AIDS）-B3、淋巴细胞性间质性肺炎（LIP）和急性肺心病。经过 30 天的高效抗逆转录病毒治疗（HAART）和氯喹治疗后，观察到肺动脉高压和右心腔的消退。
对于经常发生肺炎的儿童，如果肺炎主要与 LIP 而不是囊性纤维化相关，应考虑 AIDS。
