Bajantri Bharat, Danial Shaik, Duncalf Richard, Khaja Misbahuddin
Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, 1650 Grand Concourse, Bronx, NY 10457, USA.
Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, 1650 Grand Concourse, Bronx, NY 10457, USA.
Respir Med Case Rep. 2017 Oct 28;22:287-291. doi: 10.1016/j.rmcr.2017.10.010. eCollection 2017.
has been associated with respiratory tract infections. pneumonia-related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain. He was found to have right-side loculated complicated parapneumonic effusion and underwent drainage with a pleural catheter followed by fibrinolytic therapy. He was then found to have new-onset systemic lupus erythematosus concomitant with Mycoplasma pneumonia, leading to lupus flare and lupus nephritis. He responded well to levofloxacin, steroids, hydroxychloroquine, and mycophenolate, with complete resolution of loculated pleural effusion and symptom improvement. Our case describes the rare combination of pneumonia, parapneumonic pleural effusion, and lupus flare with lupus nephritis. Early identification and treatment can lead to better out come in young patients.
与呼吸道感染有关。肺炎相关的胸腔积液很少被报道。曾有报道出现如脑炎、心肌炎、肾小球肾炎和鼓膜炎等肺外异常情况。然而，系统性红斑狼疮的肺部表现包括肺炎、胸膜炎、间质性肺病和血栓栓塞性疾病。我们报告一例26岁男性病例，该患者因发热、咳嗽、气短伴右侧胸痛前来就诊。他被发现有右侧局限性复杂性类肺炎性胸腔积液，并通过胸腔导管进行引流，随后接受了纤维蛋白溶解疗法。之后，他被发现新发系统性红斑狼疮，同时合并支原体肺炎，导致狼疮发作和狼疮性肾炎。他对左氧氟沙星、类固醇、羟氯喹和霉酚酸酯反应良好，局限性胸腔积液完全消退，症状改善。我们的病例描述了肺炎、类肺炎性胸腔积液、狼疮发作和狼疮性肾炎这种罕见的组合情况。早期识别和治疗可使年轻患者获得更好的预后。
