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感染后继发性机化性肺炎

Secondary organizing pneumonia after infection.

作者信息

Limkul Lertluksana, Tovichien Prakarn

机构信息

Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

出版信息

World J Clin Cases. 2024 Dec 26;12(36):6877-6882. doi: 10.12998/wjcc.v12.i36.6877.

DOI:10.12998/wjcc.v12.i36.6877
PMID:39726927
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11531977/
Abstract

This editorial explores the clinical implications of organizing pneumonia (OP) secondary to pulmonary tuberculosis, as presented in a recent case report. OP is a rare condition characterized by inflammation in the alveoli, which spreads to alveolar ducts and terminal bronchioles, usually after lung injuries caused by infections or other factors. OP is classified into cryptogenic (idiopathic) and secondary forms, the latter arising after infections, connective tissue diseases, tumors, or treatments like drugs and radiotherapy. Secondary OP may be triggered by infections caused by bacteria, viruses, fungi, mycobacteria, or parasites. Key diagnostic features include subacute onset of nonspecific respiratory symptoms such as dry cough, chest pain, and exertional dyspnea. Imaging with computed tomography scans typically reveals three patterns: (1) Bilateral subpleural consolidation; (2) Nodular consolidation; and (3) A reticular pattern. Bronchoscopy with bronchoalveolar lavage helps exclude other causes. Standard treatment consists of corticosteroid therapy tapered over 6 months to 12 months. This editorial highlights clinical and diagnostic strategies to ensure timely and effective patient care.

摘要

这篇社论探讨了继发于肺结核的机化性肺炎(OP)的临床意义,正如最近一篇病例报告中所呈现的那样。OP是一种罕见的病症,其特征为肺泡炎症,通常在由感染或其他因素导致肺部损伤后,炎症会扩散至肺泡管和终末细支气管。OP分为隐源性(特发性)和继发性两种形式,后者在感染、结缔组织病、肿瘤或药物及放疗等治疗后出现。继发性OP可能由细菌、病毒、真菌、分枝杆菌或寄生虫引起的感染触发。关键的诊断特征包括非特异性呼吸道症状的亚急性发作,如干咳、胸痛和劳力性呼吸困难。计算机断层扫描成像通常显示三种模式:(1)双侧胸膜下实变;(2)结节状实变;(3)网状模式。支气管镜检查及支气管肺泡灌洗有助于排除其他病因。标准治疗包括在6个月至12个月内逐渐减量的皮质类固醇疗法。这篇社论强调了确保及时有效护理患者的临床和诊断策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c1/11531977/1f807e192b82/WJCC-12-6877-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c1/11531977/1f807e192b82/WJCC-12-6877-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c1/11531977/1f807e192b82/WJCC-12-6877-g001.jpg

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本文引用的文献

1
Organizing pneumonia secondary to pulmonary tuberculosis: A case report.肺结核继发机化性肺炎:一例报告
World J Clin Cases. 2024 Sep 16;12(26):5974-5982. doi: 10.12998/wjcc.v12.i26.5974.
2
Organizing pneumonia and COVID-19.机化性肺炎与 COVID-19。
Am J Med Sci. 2023 Dec;366(6):458-463. doi: 10.1016/j.amjms.2023.09.023. Epub 2023 Sep 30.
3
Resolution of an insidious and migratory Mycobacterium tuberculosis-associated secondary organizing pneumonia: a case report and literature review.隐匿性和迁徙性结核分枝杆菌相关的继发性机化性肺炎的消退:病例报告和文献复习。
BMC Infect Dis. 2023 Jun 1;23(1):372. doi: 10.1186/s12879-023-08334-5.
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A review of organizing pneumonia.机化性肺炎综述
JAAPA. 2023 Mar 1;36(3):16-19. doi: 10.1097/01.JAA.0000918776.59717.eb.
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Organizing pneumonia.机化性肺炎
Radiologia (Engl Ed). 2022 Dec;64 Suppl 3:240-249. doi: 10.1016/j.rxeng.2022.08.002.
6
Algorithmic Approach to the Diagnosis of Organizing Pneumonia: A Correlation of Clinical, Radiologic, and Pathologic Features.机化性肺炎诊断的算法方法:临床、放射学和病理学特征的相关性
Chest. 2022 Jul;162(1):156-178. doi: 10.1016/j.chest.2021.12.659. Epub 2022 Jan 14.
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Comparison of clinical features and prognosis in patients with cryptogenic and secondary organizing pneumonia.隐源性和继发性机化性肺炎患者的临床特征和预后比较。
BMC Pulm Med. 2021 Oct 29;21(1):336. doi: 10.1186/s12890-021-01707-z.
8
Secondary organizing pneumonia after recovery of mild COVID-19 infection.轻度 COVID-19 感染康复后发生的机化性肺炎。
J Med Virol. 2022 Jan;94(1):417-423. doi: 10.1002/jmv.27360. Epub 2021 Oct 5.
9
[Cryptogenic organizing pneumonia versus secondary organizing pneumonia].[隐源性机化性肺炎与继发性机化性肺炎]
Pathologe. 2021 Feb;42(1):55-63. doi: 10.1007/s00292-020-00903-8. Epub 2021 Jan 18.
10
Pulmonary tuberculosis presenting secondary organizing pneumonia with organized polypoid granulation tissue: case series and review of the literature.表现为继发性机化性肺炎伴机化性息肉样肉芽组织形成的肺结核:病例系列和文献复习。
BMC Pulm Med. 2020 Sep 22;20(1):252. doi: 10.1186/s12890-020-01292-7.