Nukaya Takuhisa, Ishikawa Kiyohito, Takahara Kiyoshi, Takenaka Masashi, Zennami Kenji, Ichino Manabu, Sasaki Hitomi, Sumitomo Makoto, Shiroki Ryoichi
Department of Urology Fujita Health University School of Medicine Toyoake Aichi Japan.
IJU Case Rep. 2024 Feb 27;7(3):213-216. doi: 10.1002/iju5.12705. eCollection 2024 May.
Postoperative pneumonia is very rare.
A 71-year-old male patient with prostate cancer (cT2bN0M0) underwent a robotic-assisted radical prostatectomy. On the 5th postoperative day, the patient developed chills and a fever of 39.2°C. Chest radiography revealed decreased permeability in the right middle lung field, leading to the diagnosis of postoperative pneumonia. Antimicrobial therapy was initiated immediately. Blood tests on postoperative day 10 revealed mild liver function abnormalities, electrolyte abnormalities, and a markedly elevated inflammatory response. pneumonia was suspected based on blood sample results and systemic symptoms, such as diarrhea and nausea. Furthermore, antigens were detected in the patient's urine, prompting further administration of levofloxacin. The patient's subsequent clinical course was favorable.
When bacterial pneumonia fails to respond to antimicrobial therapy and systemic symptoms develop, atypical pneumonia, caused by pathogens such as , should be considered even in cases of postoperative pneumonia.
术后肺炎非常罕见。
一名71岁的前列腺癌男性患者(cT2bN0M0)接受了机器人辅助根治性前列腺切除术。术后第5天,患者出现寒战,体温达39.2°C。胸部X线检查显示右中肺野透亮度降低,诊断为术后肺炎。立即开始抗菌治疗。术后第10天的血液检查显示轻度肝功能异常、电解质异常以及炎症反应明显升高。根据血液样本结果和腹泻、恶心等全身症状怀疑有肺炎。此外,在患者尿液中检测到 抗原,促使进一步给予左氧氟沙星。患者随后的临床病程良好。
当细菌性肺炎对抗菌治疗无反应且出现全身症状时,即使是术后肺炎病例,也应考虑由 等病原体引起的非典型肺炎。