Asai Nobuhiro, Yokoi Toyoharu, Nishiyama Naoya, Koizumi Yusuke, Sakanashi Daisuke, Kato Hideo, Hagihara Mao, Suematsu Hiroyuki, Yamagishi Yuka, Mikamo Hiroshige
Department of Clinical Infectious Diseases, Aichi Medical University School of Medicine, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.
Department of Pathology, Nagoya Ekisaikai Hospital, Nagoya, Aichi, Japan.
BMC Infect Dis. 2017 Aug 15;17(1):572. doi: 10.1186/s12879-017-2677-1.
Some reported that organizing pneumonia (OP) may occur after influenza A infections including swine-origin influenza A (H1N1). However, OP associated with influenza B infection has never been reported. We report the first case of secondary OP associated with viral pneumonia caused by influenza B.
A 23-year old woman was diagnosed as viral pneumonia caused by type B influenza. Despite of antiviral therapy, abnormal chest shadows were not improved. Bronchoscopy and transbronchial lung biopsy showed organizing pneumonia due to viral pneumonia caused by influenza B. Corticosteroid therapy was started at 30 mg daily (0.5 mg/kg), and the dose was reduced to 25, 20, 15 or 10 mg per day every month with symptomatic and radiological resolution. Even after corticosteroid therapy was discontinued, we did not confirm disease recurrence.
Physicians should be aware of the possibility for SOP and severe viral pneumonia even in case of type B as well as type A influenza infections.
一些报告指出，包括甲型H1N1流感在内的甲型流感感染后可能会发生机化性肺炎（OP）。然而，与乙型流感感染相关的OP从未有过报道。我们报告首例与乙型流感引起的病毒性肺炎相关的继发性OP。
一名23岁女性被诊断为乙型流感引起的病毒性肺炎。尽管进行了抗病毒治疗，但胸部异常阴影并未改善。支气管镜检查和经支气管肺活检显示为乙型流感引起的病毒性肺炎导致的机化性肺炎。开始使用皮质类固醇治疗，每日30毫克（0.5毫克/千克），每月将剂量减至25、20、15或10毫克/天，直至症状和影像学表现消退。即使在停用皮质类固醇治疗后，我们也未确认疾病复发。
医生应意识到，即使在乙型流感以及甲型流感感染的情况下，也有可能发生继发性OP和严重病毒性肺炎。
