Shima Natsuki, Nakamura Jun, Saito Keisuke, Kamata Yasuyuki, Nagatani Katsuya, Nagashima Takao, Iwamoto Masahiro, Akine Dai, Saito Tatsuya, Sato Kojiro, Minota Seiji
Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan.
Health Service Center, Jichi Medical University, Japan.
Intern Med. 2020 May 1;59(9):1223-1226. doi: 10.2169/internalmedicine.3982-19. Epub 2020 Feb 12.
A 72-year-old woman was admitted to our hospital with bilateral pleural effusions. She had a 31-year history of systemic lupus erythematosus and had been treated with prednisolone and azathioprine. Pleural fluid culture revealed Salmonella enterica subsp. arizonae infection. This pathogen rarely infects humans but is commonly found in the gut flora of reptiles, especially snakes. Our patient had not come in contact with reptiles. Despite antibiotic therapies and negative pleural cultures, the pleural effusion persisted. Colon cancer was detected concomitantly, and she finally died. The autopsy revealed that the pleuritis was due to underlying diffuse large B cell lymphoma.
一名72岁女性因双侧胸腔积液入住我院。她有31年的系统性红斑狼疮病史，一直在接受泼尼松龙和硫唑嘌呤治疗。胸腔积液培养显示感染了亚利桑那沙门氏菌亚种。这种病原体很少感染人类，但常见于爬行动物的肠道菌群中，尤其是蛇。我们的患者未曾接触过爬行动物。尽管进行了抗生素治疗且胸腔培养结果为阴性，但胸腔积液仍持续存在。同时检测出结肠癌，她最终死亡。尸检显示胸膜炎是由潜在的弥漫性大B细胞淋巴瘤引起的。
