Department of Infectious Diseases, Huashan Hospital, Fudan University, 12, Middle Wulumuqi Road, Shanghai, 200040, China.
Department of Infectious Diseases, Chongqing Kaixian People's Hospital, 8, Ankang Road, Chongqing, 405499, China.
Infect Dis Poverty. 2018 Apr 27;7(1):34. doi: 10.1186/s40249-018-0419-2.
Primary pulmonary amoeba is very rare and here we report a case of a 68-year-old man presenting with primary pulmonary amoeba after undergoing chemotherapy for lung adenocarcinoma.
In October 2016, the man aged 68 was admitted to our hospital because of repeated cough for 8 months and hemoptysis for 1 month. He was diagnosed lung adenocarcinoma and underwent surgery in 2012 without receiving chemotherapy. In March 2016, the patients suffered recurrence of cancer and was treated with chemotherapy. After 2 months of chemotherapy, the patient had consistent cough with white sputum, and chest CT showed a local lung nodule. The physicians suspected that the patient had pulmonary infectious diseases, and he was treated with empirical antibacterial treatment. However, his symptom wasn't relieved and later the percutaneous lung biopsy found trophozites of Entamoeba histolytica. After administration of metronidazole, the symptoms of the patient were markedly relieved and the lesions were absorbed.
In such cases where patients with pulmonary nodules were in immunodeficiency state and had adequate but ineffective anti-bacterial treatment, Entamoeba histolytica infection could be one of the rare causes. Percutaneous lung biopsy should be recommended and specific dying for parasites should be done when necessary.
原发性肺阿米巴病非常罕见，在此我们报告一例 68 岁男性，在因肺腺癌接受化疗后出现原发性肺阿米巴病。
2016 年 10 月，该 68 岁男性因反复咳嗽 8 个月和咯血 1 个月而入院。他被诊断为肺腺癌，于 2012 年接受了手术治疗，未接受化疗。2016 年 3 月，患者癌症复发，接受化疗。化疗 2 个月后，患者持续咳嗽，咳白痰，胸部 CT 显示局部肺结节。医生怀疑患者患有肺部传染病，给予经验性抗菌治疗。然而，他的症状没有缓解，后来经经皮肺活检发现溶组织内阿米巴滋养体。给予甲硝唑治疗后，患者症状明显缓解，病变吸收。
对于此类肺部结节患者处于免疫抑制状态，且接受了充分但无效的抗菌治疗的情况，溶组织内阿米巴感染可能是罕见病因之一。应推荐经皮肺活检，必要时进行寄生虫特异性检查。
