Saliba Jad, Grall Maximilien, Saliba Christian
Internal Medicine, Centre Hospitalier Universitaire Charles Nicolle Hospital, Rouen, FRA.
General Surgery, Lebanese American University-Medical Center, Beirut, LBN.
Cureus. 2021 Feb 24;13(2):e13533. doi: 10.7759/cureus.13533.
Henoch-Schönlein purpura (HSP) is a small-vessel vasculitis with cutaneous, articular, gastrointestinal, and renal manifestations. Leukocytoclastic vasculitis and IgA deposits are classically found when involved skin and kidneys are biopsied. The disease's etiology remains unknown, although many bacterial and viral infections have been described as triggering factors. A 53-year-old woman presented with fever, arthralgia, and non-thrombocytopenic purpura. She also had a segmental pulmonary collection with peripheral alveolar consolidation. and mycobacteria growth was found on sputum cultures. In addition to intravenous antibiotics and anti-mycotic drugs, high-dose corticosteroids were urgently administered due to the development of severe intestinal symptoms. A cutaneous biopsy later confirmed HSP. Microbial identification yielded . In the review of the literature, we only found 12 cases of and one case of complex that were associated with HSP. Nearly, half of the cases responded to anti-mycotic treatment alone. The rest required immunosuppressants. We report the first case of pulmonary infection in HSP. This disease process can have a severe course, which requires rapid recognition and treatment.
过敏性紫癜（HSP）是一种具有皮肤、关节、胃肠道和肾脏表现的小血管炎。当对受累的皮肤和肾脏进行活检时，经典地会发现白细胞破碎性血管炎和IgA沉积。尽管许多细菌和病毒感染已被描述为触发因素，但该疾病的病因仍不清楚。一名53岁女性出现发热、关节痛和非血小板减少性紫癜。她还出现了节段性肺实变伴外周肺泡实变，痰培养发现分枝杆菌生长。除静脉使用抗生素和抗真菌药物外，由于出现严重肠道症状，紧急给予了大剂量皮质类固醇。后来皮肤活检证实为HSP。微生物鉴定结果为 。在文献回顾中，我们仅发现12例 以及1例 复合体与HSP相关。几乎一半的病例仅对抗真菌治疗有反应。其余病例需要免疫抑制剂。我们报告了首例HSP合并 肺部感染的病例。该病程可能较为严重，需要快速识别和治疗。
