由伯氏考克斯体引起的肺部炎性假瘤。病例报告及文献复习。

Pulmonary inflammatory pseudotumor due to Coxiella burnetii. Case report and literature review.

作者信息

Polo M F, Mastrandrea S, Santoru L, Arcadu A, Masala G, Marras V, Bagella G, Sechi M M, Tanda F, Pirina P

机构信息

Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.

出版信息

Microbes Infect. 2015 Nov-Dec;17(11-12):795-8. doi: 10.1016/j.micinf.2015.08.008. Epub 2015 Sep 3.

DOI:10.1016/j.micinf.2015.08.008

PMID:26342254

Abstract

A 58-year-old man was admitted because of respiratory failure, episodic fever with chilling, cough, malaise, fatigue, myalgia and weight loss lasting for at least one month. Chest x-rays and CT scan of the chest showed bilateral pulmonary consolidations in upper lobes, the left lower lobe, and mediastinal lymphadenopathy. Bronchoscopy with cytology was unremarkable. A needle CT-guided lung biopsy documented an inflammatory pseudotumor, lymphoplasmacytic type. Serology showed high titer antibodies to phase II Coxiella burnetii infection. Therapy with doxycycline and hydroxychloroquine for three months led to a complete resolution of symptoms and radiological findings, and a marked decrease in titers to Q fever.

摘要

一名58岁男性因呼吸衰竭入院，伴有间歇性发热、寒战、咳嗽、不适、乏力、肌痛和体重减轻，持续至少一个月。胸部X光片和胸部CT扫描显示上叶、左肺下叶双侧肺部实变及纵隔淋巴结肿大。支气管镜检查及细胞学检查未见异常。CT引导下经皮肺穿刺活检证实为淋巴细胞浆细胞型炎性假瘤。血清学检查显示抗II期伯氏考克斯体感染抗体滴度很高。给予强力霉素和羟氯喹治疗三个月后，症状和影像学表现完全缓解，Q热抗体滴度显著下降。