Hayama Manabu, Shime Nobuaki, Mio Tadashi
Department of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto-shi, Kyoto, Japan.
Department of Emergency and Critical Care Medicine, National Hospital Organization Kyoto Medical Center, Kyoto-shi, Kyoto, Japan.
BMJ Case Rep. 2014 May 23;2014:bcr2014203764. doi: 10.1136/bcr-2014-203764.
A 54-year-old man presented to our emergency department with fever and dyspnoea. He required vigorous haemodynamic support and mechanical ventilation for hypotensive distributive shock with hypoalbuminaemia, haemoconcentration, rhabdomyolysis and acute renal failure, consistent with idiopathic systemic capillary leak syndrome. Left lung consolidation and hypoxaemia were observed 6 days after admission. Sputum smear revealed the presence of acute angled branching hyphae, consistent with a diagnosis of invasive pulmonary aspergillosis. Antifungal therapy was administered and mechanical ventilation discontinued on day 66. The patient recovered and was discharged from the hospital on day 185.
一名54岁男性因发热和呼吸困难前来我院急诊科就诊。他因伴有低白蛋白血症、血液浓缩、横纹肌溶解和急性肾衰竭的低血压性分布性休克，需要积极的血流动力学支持和机械通气，这与特发性系统性毛细血管渗漏综合征相符。入院6天后观察到左肺实变和低氧血症。痰涂片显示存在急性成角分支菌丝，符合侵袭性肺曲霉病的诊断。给予抗真菌治疗，并于第66天停止机械通气。患者康复，并于第185天出院。
