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13例HIV阴性患者的肺孢子菌肺炎病例

Thirteen Cases of Pulmonary Pneumocystis in HIV-Negative Patients.

作者信息

Bouhamdi Abir, Es-Sabbahi Btissame, Amiali Rajae, Serraj Mounia, Biaz Mohamed, Benjelloun Mohamed Chakib, Amara Bouchra

机构信息

Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR.

出版信息

Cureus. 2023 Aug 13;15(8):e43409. doi: 10.7759/cureus.43409. eCollection 2023 Aug.

Abstract

We report 13 cases of pulmonary pneumocystis (PCP) in human immunodeficiency virus (HIV)-uninfected patients. Of eight males and five females, with a mean age of 55 years, one had breast neoplasia, two had common variable immunodeficiency (CVID), one had an autoimmune disease "Goodpasture's syndrome", and one had idiopathic fibrosis (nonspecific interstitial pneumonia/fibrosis (NIP)) undergoing prolonged corticosteroid therapy for two years, with no known immunosuppression in the remaining cases. The clinical picture was characterized by constant dyspnea and severe hypoxia in 11 cases. Lymphopenia was present in nine cases with an average rate of 920.76 elements/mm. The diagnosis was confirmed by isolation of  (PCJ) from induced sputum, except in two cases where analysis of bronchoalveolar lavage (BAL) fluid was required. With trimethoprim/sulfamethoxazole (TMP/SMX) and corticosteroid therapy, the course was favorable in all cases. Prophylactic treatment was indicated in three cases.

摘要

我们报告了13例人类免疫缺陷病毒(HIV)未感染患者的肺孢子菌肺炎(PCP)病例。其中8名男性和5名女性,平均年龄55岁,1例患有乳腺肿瘤,2例患有常见可变免疫缺陷(CVID),1例患有自身免疫性疾病“Goodpasture综合征”,1例患有特发性纤维化(非特异性间质性肺炎/纤维化(NIP)),接受了两年的长期皮质类固醇治疗,其余病例无已知免疫抑制情况。临床表现为11例持续呼吸困难和严重缺氧。9例出现淋巴细胞减少,平均比率为920.76个细胞/mm。除2例需要分析支气管肺泡灌洗(BAL)液外,其余病例通过从诱导痰中分离出肺孢子菌(PCJ)确诊。使用甲氧苄啶/磺胺甲恶唑(TMP/SMX)和皮质类固醇治疗后,所有病例病情均好转。3例需要预防性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44df/10496727/b1c5f4a80596/cureus-0015-00000043409-i01.jpg

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