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中东呼吸综合征冠状病毒感染患者疑似机化性肺炎的成功治疗:一例报告

Successful treatment of suspected organizing pneumonia in a patient with Middle East respiratory syndrome coronavirus infection: a case report.

作者信息

Kim Insu, Lee Jeong Eun, Kim Kye-Hyung, Lee Shinwon, Lee Kwangha, Mok Jeong Ha

机构信息

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

出版信息

J Thorac Dis. 2016 Oct;8(10):E1190-E1194. doi: 10.21037/jtd.2016.09.26.

Abstract

A 54-year-old man with Middle East respiratory syndrome coronavirus (MERS-CoV) infection was transferred to our hospital. We initiated anti-viral drugs and supportive care. The patient's fever and chills disappeared 3 days after admission and the results of serial follow-up reverse transcription-polymerase chain reaction testing for MERS-CoV was negative soon thereafter. He was discharged from the hospital 14 days after admission with no symptoms; however, he presented with a fever 7 days after discharge and was re-hospitalized. Chest radiographs showed newly developed consolidative opacity. His fever persisted for 3 days after commencing empirical antibiotics. Subsequent contrast-enhanced computed tomography (CT) of the chest showed focal patchy airspace consolidation and ground-glass opacities (GGOs) in a subpleural lesion of the right lower and left upper lobes, which was indicative of organizing pneumonia. We initiated empirical corticosteroid treatment for this illness, and his fever markedly subsided 1 day later. A chest radiograph showed improvement in the lung lesions, and he was discharged from the hospital 10 days after re-admission. The corticosteroid dose was gradually tapered over 2 months at the outpatient clinic, and a follow-up CT scan showed complete resolution of the consolidation and GGOs.

摘要

一名54岁的中东呼吸综合征冠状病毒(MERS-CoV)感染男性患者被转至我院。我们启动了抗病毒药物治疗及支持性治疗。患者入院3天后发热和寒战消失,此后连续的MERS-CoV逆转录聚合酶链反应检测结果很快转为阴性。他入院14天后无症状出院;然而,出院7天后他出现发热并再次入院。胸部X线片显示新出现的实变影。经验性使用抗生素后,他的发热持续了3天。随后的胸部增强计算机断层扫描(CT)显示右下叶和左上叶胸膜下病变处有局灶性斑片状气腔实变及磨玻璃影(GGO),提示机化性肺炎。我们针对该疾病启动了经验性糖皮质激素治疗,1天后他的发热明显消退。胸部X线片显示肺部病变有所改善,再次入院10天后他出院。糖皮质激素剂量在门诊2个月内逐渐减量,随访CT扫描显示实变和GGO完全消失。

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