[应用粒细胞集落刺激因子（G-CSF）治疗耐甲氧西林金黄色葡萄球菌（MRSA）和克柔念珠菌所致重症肺炎：1例报告]

[Treatment of severe pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) and Candida krusei with granulocyte colony-stimulating factor (G-CSF): a case report].

作者信息

Yoshida M, Yoshikawa K, Maezawa H, Shindou N, Sakamoto M, Nakazawa Y, Shiba K, Saito A, Sakai O

机构信息

Second Department of Internal Medicine, Tokyo Jikei University School of Medicine.

出版信息

Kansenshogaku Zasshi. 1993 Aug;67(8):767-71. doi: 10.11150/kansenshogakuzasshi1970.67.767.

DOI:10.11150/kansenshogakuzasshi1970.67.767

PMID:7691973

Abstract

A 24-year-old male with chronic renal failure on Continuous Ambulatory Peritoneal Dialysis (CAPD) complained of cough and dyspnea. Chest X-ray film showed a pneumonia shadow and MRSA and Candida krusei were detected in the sputum. Pneumonia improved with vancomycin and fluconazole. Treatment with methylprednisolone was needed for retinodialysis. After this treatment, pneumonia deteriorated. Pneumonia did not improve with vancomycin and anti-fungal agents. This severe pneumonia was improved with a combination therapy of vancomycin, miconazole and G-CSF. A combination therapy of antibiotics and G-CSF is considered to be effective for severe pneumonia.

摘要

一名24岁接受持续性非卧床腹膜透析（CAPD）治疗的慢性肾衰竭男性患者，主诉咳嗽和呼吸困难。胸部X光片显示有肺炎阴影，痰中检测出耐甲氧西林金黄色葡萄球菌（MRSA）和克柔念珠菌。使用万古霉素和氟康唑后肺炎有所改善。视网膜透析需要使用甲泼尼龙进行治疗。此次治疗后，肺炎病情恶化。使用万古霉素和抗真菌药物后肺炎并未改善。联合使用万古霉素、咪康唑和粒细胞集落刺激因子（G-CSF）后，这种严重的肺炎病情得到改善。抗生素与G-CSF联合治疗被认为对严重肺炎有效。