Albitar Hasan Ahmad Hasan, Gallo de Moraes Alice, Lim Kaiser G
Faculty of Medicine, University of Jordan, Amman, Jordan.
Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
BMJ Case Rep. 2017 Oct 19;2017:bcr-2017-220959. doi: 10.1136/bcr-2017-220959.
We highlight a rare presentation of infection in a 77-year-old woman with a clinical diagnosis of giant cell arteritis 2 months prior to presentation. She was started on 60 mg prednisone that was tapered to 10 mg after 4 weeks following her diagnosis. She presented with a 1-month progressive dyspnoea in the absence of any other symptoms. Her exposure history was significant only for a recent trip to Florida where she stayed at a hotel. Initial laboratory workup was significant for hyponatraemia (127 mmol/L). Workup including bronchoalveolar lavage (BAL) and induced sputum for gram stain, acid fast stain and bacterial culture were negative for pneumonia and other opportunistic infectious agents. However, BAL was positive for via PCR that was confirmed by a positive urinary antigen. The patient received treatment with levofloxacin that led to full resolution of her symptoms.
我们着重介绍了一名77岁女性感染的罕见病例，该患者在就诊前2个月临床诊断为巨细胞动脉炎。诊断后，她开始服用60毫克泼尼松，4周后逐渐减至10毫克。她出现了1个月的进行性呼吸困难，无任何其他症状。她的接触史仅显示近期去过佛罗里达州，住在一家酒店。初步实验室检查显示低钠血症（127 mmol/L）。包括支气管肺泡灌洗（BAL）以及诱导痰行革兰氏染色、抗酸染色和细菌培养在内的检查，均未发现肺炎及其他机会性感染病原体。然而，BAL经聚合酶链反应检测对[具体病原体未明确]呈阳性，尿[具体病原体未明确]抗原检测呈阳性进一步证实。患者接受左氧氟沙星治疗后症状完全缓解。
