Chikumoto Ayumi, Oishi Keiji, Hamada Kazuki, Matsuda Kazuki, Uehara Sho, Suetake Ryo, Yamaji Yoshikazu, Asami-Noyama Maki, Edakuni Nobutaka, Hirano Tsunahiko, Murakami Tomoyuki, Matsunaga Kazuto
Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Respir Med Case Rep. 2019 May 2;27:100851. doi: 10.1016/j.rmcr.2019.100851. eCollection 2019.
In cases showing organizing pneumonia (OP) with radiologic findings and pathological images, it is necessary to differentiate between idiopathic and secondary diseases as the cause of OP. infection as a cause of OP is not well known. We herein report two cases of secondary pulmonary cryptococcosis in immunocompromised patients who showed OP, and the usefulness of bronchoscopy and serum cryptococcal antigen test for an early diagnosis. Common to both cases was that antibiotic therapy and corticosteroid therapy were ineffective, while antifungal agents were effective. In cases of immunocompromised patients who present OP with radiologic findings or pathological images, prompt administration of antifungal treatment at an early stage is important when pulmonary cryptococcosis is identified by bronchoscopy and serum cryptococcal antigen test.
在出现具有放射学表现和病理图像的机化性肺炎(OP)的病例中,有必要区分OP的病因是特发性还是继发性疾病。作为OP病因的感染情况尚不为人所知。我们在此报告两例免疫功能低下患者出现OP的继发性肺隐球菌病病例,以及支气管镜检查和血清隐球菌抗原检测对早期诊断的有用性。两例病例的共同之处在于抗生素治疗和皮质类固醇治疗均无效,而抗真菌药物有效。对于出现具有放射学表现或病理图像的OP的免疫功能低下患者,当通过支气管镜检查和血清隐球菌抗原检测确诊为肺隐球菌病时,早期及时给予抗真菌治疗很重要。