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一名75岁男性肺部空洞形成的罕见病因。

Rare cause of pulmonary cavitation in a 75-year-old man.

作者信息

Al-Sheikhli Jaffar, Taqi Hussein, Drake John, Habib Ayaaz

机构信息

Department of General Medicine, Heart of England NHS Foundation Trust, Birmingham, UK.

Cardiology, Nottingham City Hospital, Nottingham, UK.

出版信息

BMJ Case Rep. 2018 Jan 10;2018:bcr-2017-222792. doi: 10.1136/bcr-2017-222792.

Abstract

A 75-year-old man of Asian descent presented to the acute medical unit with signs and symptoms suggestive of a community-acquired pneumonia. He had multiple comorbidities and was relatively immunocompromised as a result. Initial investigations supported the diagnosis of community-acquired pneumonia complicated by a cavitating lung lesion, and the patient was treated as per hospital guidelines. He continued to deteriorate despite appropriate therapy and developed a hydropneumothorax, requiring the insertion of a chest drain. A diagnosis of pulmonary mucormycosis () was made based on microbiology results from pleural aspirate, and patient was treated with intravenous antifungals. The patient was referred to the thoracic team for consideration of surgical intervention but was not suitable due to his multiple comorbidities. This case highlighted the importance of early consideration of fungal infection in patients with multiple risk factors and the need for aggressive therapy to ensure the best outcome.

摘要

一名75岁的亚裔男性因出现社区获得性肺炎的体征和症状,被送至急症科。他患有多种合并症,因此免疫功能相对低下。初步检查支持社区获得性肺炎合并肺空洞性病变的诊断,患者按照医院指南接受治疗。尽管进行了适当治疗,他的病情仍持续恶化,并发展为液气胸,需要插入胸腔引流管。根据胸腔穿刺液的微生物学结果,诊断为肺毛霉菌病(),患者接受了静脉抗真菌治疗。该患者被转介至胸外科团队考虑手术干预,但由于他的多种合并症而不适合手术。该病例凸显了对于具有多种危险因素的患者早期考虑真菌感染的重要性,以及积极治疗以确保最佳治疗效果的必要性。

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