Matsumoto K, Komori A, Harada N, Ohsima T, Inoue H, Ninomiya K, Hara N
Department of Internal Medicine, Kyushu Koseinenkin Hospital, Kitakyushu.
Fukuoka Igaku Zasshi. 1995 Mar;86(3):99-104.
We present an unusual case of 30-year-old man who was admitted to our hospital with dysesthesia of the limbs and skin eruptions. Polyarteritis nodosa was diagnosed based on the histopathological examination of sural nerve and renal biopsies. A month after initiation of corticosteroid therapy, a small infiltrative shadow was detected in the right mid-lung field by chest X-ray. Aspergillus infection was suspected based on a culture of bronchial lavage fluid. Despite intravenous administration of the antifungal agents, miconazole and fluconazole, a thin-walled cavity with a fungus ball gradually formed in the infiltrative lesion. The patient's clinicopathological findings were consistent with a diagnosis of chronic necrotizing pulmonary aspergillosis, a rare aspergillus infection in the lung. Treatment with intracavitary instillation of amphotericin B proved effective.
我们报告一例罕见病例，一名30岁男性因肢体感觉异常和皮肤疹入院。根据腓肠神经和肾脏活检的组织病理学检查诊断为结节性多动脉炎。在开始使用皮质类固醇治疗一个月后，胸部X线检查发现右肺中叶有一个小的浸润性阴影。根据支气管灌洗液培养怀疑有曲霉菌感染。尽管静脉注射了抗真菌药物咪康唑和氟康唑，但浸润性病变中逐渐形成了一个带有真菌球的薄壁空洞。患者的临床病理表现符合慢性坏死性肺曲霉病的诊断，这是一种罕见的肺部曲霉菌感染。腔内注射两性霉素B治疗有效。
