Ide Hiromi, Yamaji Yoshikazu, Tobino Kazunori, Okahisa Masanobu, Murakami Kojin, Goto Yuki, Sueyasu Takuto, Nishizawa Saori, Yoshimine Kohei, Munechika Miyuki, Oya Masafumi, Hiraki Yuka
Department of Respiratory Medicine, Iizuka Hospital, Japan.
Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan.
Case Rep Pulmonol. 2019 Mar 7;2019:3981681. doi: 10.1155/2019/3981681. eCollection 2019.
We herein report the case of a 37-year-old immunocompetent man who died from pneumonia (PCP). He was initially treated for an acute exacerbation of interstitial pneumonia; however, the elevation of the patient's serum (1-3) -D glucan (BG) level suggested the possibility of PCP and sulfamethoxazole trimethoprim was added. A postmortem pathological examination and retrospective Grocott's methenamine silver (GMS) staining of the bronchoalveolar lavage fluid (BALF), which was obtained on the day of admission, revealed PCP. The present case suggests that it is essential to perform a BG assay and GMS staining of BALF specimens when patients show diffuse ground-glass opacity on chest computed tomography, regardless of their immune status.
我们在此报告一例37岁免疫功能正常的男性因肺炎(肺孢子菌肺炎)死亡的病例。他最初因间质性肺炎急性加重接受治疗;然而,患者血清(1-3)-D葡聚糖(BG)水平升高提示肺孢子菌肺炎的可能性,遂加用复方磺胺甲恶唑。入院当天获取的支气管肺泡灌洗液(BALF)的尸检病理检查及回顾性格罗科特六胺银(GMS)染色显示为肺孢子菌肺炎。本病例提示,当患者胸部计算机断层扫描显示弥漫性磨玻璃影时,无论其免疫状态如何,对BALF标本进行BG检测和GMS染色至关重要。