经支气管肺冷冻活检诊断类风湿关节炎患者肺部隐球菌病
Pulmonary Cryptococcosis Diagnosed by a Transbronchial Lung Cryobiopsy in a Patient with Rheumatoid Arthritis.
机构信息
Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Japan.
Department of Endocrinology and Rheumatology, Ohara Healthcare Foundation, Kurashiki Central Hospital, Japan.
出版信息
Intern Med. 2023 Feb 15;62(4):583-587. doi: 10.2169/internalmedicine.9764-22. Epub 2022 Jul 29.
A 77-year-old woman with seronegative rheumatoid arthritis who was being treated with prednisolone (8 mg/day) and methotrexate (12 mg/week) visited our hospital with an 11-day history of a fever and dyspnea. Chest computed tomography showed infiltration in the right lower lobe. A transbronchial lung cryobiopsy (TBLC) showed cryptococcal cells, and bronchoalveolar lavage fluid later showed growth of Cryptococcus neoformans. She was treated with amphotericin B and flucytosine for about four weeks, and the pulmonary shadows improved. The treatment was then changed to fluconazole as outpatient consolidation and maintenance therapy. A rare case of pulmonary cryptococcosis diagnosed by a TBLC is reported.
一位 77 岁的女性，患有血清阴性类风湿关节炎，正在接受泼尼松龙（8 毫克/天）和甲氨蝶呤（12 毫克/周）治疗，因发热和呼吸困难来我院就诊，病史 11 天。胸部计算机断层扫描显示右下叶浸润。经支气管镜肺冷冻活检（TBLC）显示隐球菌细胞，支气管肺泡灌洗液随后显示新型隐球菌生长。她接受了大约四周的两性霉素 B 和氟胞嘧啶治疗，肺部阴影有所改善。然后改为氟康唑作为门诊巩固和维持治疗。报告了一例经 TBLC 诊断的罕见肺隐球菌病。
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