Okamoto Masashi, Yamaoka Junko, Chikayama Satoshi, Ohishi Tohru, Nakajima Tomoki, Nakashima Toshiaki
Department of Internal Medicine, Saiseikai Kyoto Hospital, Japan.
Intern Med. 2012;51(19):2809-12. doi: 10.2169/internalmedicine.51.7921. Epub 2012 Oct 1.
A previously healthy 39-year-old woman with severe chest pain presented at our hospital. She was diagnosed with bacterial pneumonia by chest X-ray and computed tomography. Despite adequate antimicrobial treatment, she had to undergo intubation for respiratory distress and was treated with mechanical ventilation 42 hours after admission. However, her condition improved markedly after plasmapheresis. Bacterial culture specimens from the sputum, blood, and pleural fluid were positive for Pseudomonas aeruginosa (P. aeruginosa). Pseudomonas aeruginosa community-acquired pneumonia (CAP) in previously healthy individuals is very rare, rapidly progressive, and often fatal. This is the first report of the successful treatment of this life-threatening pneumonia with plasmapheresis.
一名此前健康的39岁女性因严重胸痛前来我院就诊。通过胸部X线和计算机断层扫描，她被诊断为细菌性肺炎。尽管接受了充分的抗菌治疗，但她因呼吸窘迫不得不接受插管，并在入院42小时后接受机械通气治疗。然而，在进行血浆置换后，她的病情明显好转。痰液、血液和胸腔积液的细菌培养标本显示铜绿假单胞菌呈阳性。此前健康个体发生的铜绿假单胞菌社区获得性肺炎（CAP）非常罕见，进展迅速，且往往致命。这是首例关于通过血浆置换成功治疗这种危及生命的肺炎的报告。
