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一名最初被怀疑患有肺结核的护士的肺隐球菌病

Pulmonary Cryptococcosis in a Nurse Initially Suspected of Having Pulmonary Tuberculosis.

作者信息

Ogawa Hidemi, Urushibara Takashi, Kasai Hajime, Ikeda Hideki, Shinozaki Toshihide

机构信息

Department of Respiratory Medicine, Kimitsu Chuo Hospital, Kisarazu, Chiba, Japan.

Department of Respirology, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.

出版信息

Am J Case Rep. 2020 Jan 11;21:e919267. doi: 10.12659/AJCR.919267.

Abstract

BACKGROUND Pulmonary cryptococcosis can be associated with various imaging findings and can occur in immunocompetent hosts. It is sometimes difficult to distinguish pulmonary cryptococcosis from pulmonary tuberculosis based on imaging findings. CASE REPORT A 34-year-old female nurse who worked in an endoscopy examination room visited our hospital because of an abnormal lung shadow. At her workplace, a gastrointestinal endoscopy had been performed on a patient with infectious tuberculosis. The nurse was asymptomatic, and acid-fast staining and culture of her sputum were negative. Chest computed tomography depicted multiple nodules distributed along the bronchi. An acid-fast smear test of bronchial lavage was negative and cytological investigations revealed many yeast-like fungi. Fluconazole was administered and the computed tomography findings improved. CONCLUSIONS It is important to consider cryptococcosis, even in patients suspected of having tuberculosis.

摘要

背景

肺隐球菌病可伴有多种影像学表现,可发生于免疫功能正常的宿主。有时根据影像学表现难以将肺隐球菌病与肺结核区分开来。病例报告:一名在内镜检查室工作的34岁女护士因肺部阴影异常前来我院就诊。在她的工作场所,曾对一名感染性肺结核患者进行过胃肠内镜检查。该护士无症状,痰涂片抗酸染色及培养均为阴性。胸部计算机断层扫描显示沿支气管分布有多个结节。支气管灌洗抗酸涂片检查为阴性,细胞学检查发现许多酵母样真菌。给予氟康唑治疗后,计算机断层扫描结果有所改善。结论:即使在疑似患有结核病的患者中,也应考虑隐球菌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c79/6977631/35755e88b174/amjcaserep-21-e919267-g001.jpg

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