Berger R, Kraman S
Arch Intern Med. 1981 Aug;141(9):1223-5.
A previously healthy patient who had received oral prednisone, 30 mg/day for 12 days, was initially seen with acute respiratory failure caused by miliary blastomycosis. This case was even more unusual because the pulmonary involvement was preceded by monoarticular arthralgias immediately before the corticosteroid therapy. The time course of these events--arthralgias, short-course prednisone therapy, and acute miliary blastomycosis--strongly suggests a relationship other than just coincidental. Treatment consisted of intravenous amphotericin B and discontinuation of therapy with the corticosteroids, and our patient is satisfactorily recovering.
一名既往健康的患者接受了为期12天、每日30毫克的口服泼尼松治疗，最初表现为粟粒性芽生菌病引起的急性呼吸衰竭。该病例更为特殊，因为在使用皮质类固醇治疗前，肺部受累之前出现了单关节关节痛。这些事件——关节痛、短期泼尼松治疗和急性粟粒性芽生菌病——的时间进程强烈表明它们之间存在某种关联，而非仅仅是巧合。治疗包括静脉注射两性霉素B并停用皮质类固醇，我们的患者正在令人满意地康复。
