Shen Hsiang-Shi, Lai Yu-Ting, Tsai Han-Chen, Chang Shi-Chuan
Department of Chest Medicine Taipei Veterans General Hospital Taipei Taiwan.
Division of Pulmonology, Department of Internal Medicine Kao-Hsiung Veterans General Hospital Tainan Branch Tainan Taiwan.
Respirol Case Rep. 2021 May 6;9(6):e00765. doi: 10.1002/rcr2.765. eCollection 2021 Jun.
Acute silicoproteinosis is a disease that develops in weeks, and lasting for years, after massive exposure to silica dust in relatively closed spaces. It was rare, but the cases have recently increased worldwide due to the development of artificial stone industry. Compared with traditional silicosis, artificial stone-associated silicosis is more rapidly progressive and lethal. Hence, a correct diagnosis and optimal treatment are crucial. Here, we present the clinical course of a 33-year-old artificial stonemason who suffered from acute silicoproteinosis with concurrent Cryptococcus infection resulting in profound respiratory failure. This patient was treated by bronchoscope-assisted therapeutic segmental lung lavage and antifungal agent, under mechanical ventilator and ECMO support and recovered well. A brief review of acute silicoproteinosis and artificial stone-associated silicosis is also presented and highlights the new form of industry exposure to silica.
急性硅蛋白沉着症是一种在相对封闭空间中大量接触二氧化硅粉尘数周内发病且病程持续数年的疾病。该病过去较为罕见,但近年来由于人造石工业的发展,全球范围内的病例有所增加。与传统矽肺相比,人造石相关矽肺进展更快且更具致死性。因此,正确诊断和优化治疗至关重要。在此,我们报告一名33岁人造石匠的临床病程,他患有急性硅蛋白沉着症并并发隐球菌感染,导致严重呼吸衰竭。该患者在机械通气和体外膜肺氧合(ECMO)支持下,接受了支气管镜辅助治疗性肺段灌洗及抗真菌药物治疗,恢复良好。本文还简要回顾了急性硅蛋白沉着症和人造石相关矽肺,并强调了工业接触二氧化硅的新形式。