Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan.
Intern Med. 2022 Oct 15;61(20):3089-3093. doi: 10.2169/internalmedicine.9021-21. Epub 2022 Mar 12.
Pulmonary artery pseudoaneurysms (PAPs) are rare but can cause massive hemoptysis if they rupture. Infectious PAPs are often treated by surgery or transcatheter embolization and are rarely treated conservatively with antibiotics. We herein report a case of PAP treated conservatively in a 21-year-old woman with lung abscess. Except for one massive hemoptysis early in the course, the patient responded well to the empirical therapy with ampicillin/sulbactam and systemic hemostatic agents. After six weeks of antibiotics, the pseudoaneurysm disappeared. Conservative therapy with careful observation can be considered in small infectious PAPs when there is a good clinical response to initial conservative therapy.
肺动脉假性动脉瘤（PAP）较为罕见，但如果破裂可引起大量咯血。感染性 PAP 常通过手术或经导管栓塞治疗，很少使用抗生素进行保守治疗。本文报告了一例肺脓肿患者的 PAP 经保守治疗的病例。除了病程早期发生一次大咯血外，患者对氨苄西林/舒巴坦和全身性止血药物的经验性治疗反应良好。经过六周的抗生素治疗，假性动脉瘤消失。当对初始保守治疗有良好的临床反应时，对于小的感染性 PAP 可考虑采用保守治疗并密切观察。
