Morita Mitsunori, Tomioka Hiromi
Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Department of Respiratory Medicine, Japan.
Respir Med Case Rep. 2019 Sep 9;28:100931. doi: 10.1016/j.rmcr.2019.100931. eCollection 2019.
An 80-year-old man was admitted to the hospital because of fever, bloody sputum and exertional dyspnea of 3 days. Laboratory tests showed anemia and increase of the C-reactive protein level. A chest computed tomography scan revealed diffuse bilateral ground-glass opacities. Bronchoalveolar lavage confirmed the clinical diagnosis of diffuse alveolar hemorrhage (DAH). After methylprednisolone pulse therapy, was detected in the blood cultures. A diagnosis of infective endocarditis was made according to the Modified Duke's criteria. The causes of DAH are certainly diverse; however, we should consider infective endocarditis as one of the etiologies of DAH.
一名80岁男性因发热、咯血痰和劳力性呼吸困难3天入院。实验室检查显示贫血及C反应蛋白水平升高。胸部计算机断层扫描显示双侧弥漫性磨玻璃影。支气管肺泡灌洗确诊为弥漫性肺泡出血（DAH）。甲基强的松龙冲击治疗后，血培养中检测到[具体病原体未给出]。根据改良的杜克标准诊断为感染性心内膜炎。DAH的病因肯定多种多样；然而，我们应将感染性心内膜炎视为DAH的病因之一。
