Sato S, Suwabe A, Osanai K, Kudo Y, Kato S, Takahashi H, Higuchi J, Takahashi K, Tomoike H
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 May;31(5):636-42.
A case in which P. carinii was observed in bronchoalveolar lavage fluid during steroid therapy for interstitial pneumonia in a 63-year-old man is reported, he had received steroid therapy for interstitial pneumonia of unknown origin. Three weeks later, he developed acute pneumonia with Streptococcus pneumoniae, and simultaneously P. carinii was detected in the bronchoalveolar lavage fluid. Both the pneumonic shadows and P. carinii disappeared following intravenous infusion of penicillin and rapid reduction of steroid. Electron microscopic analysis of P. carinii demonstrated numerous tubular expansions and endogenies of P. carinii, suggesting that P. carinii was growing in the intra-alveolar spaces. Phospholipid analysis demonstrated a transient increase in total phospholipid content during P. carinii pneumonia, suggesting that P. carinii can affect surfactant metabolism.
报告了一例63岁男性在接受类固醇治疗间质性肺炎期间，支气管肺泡灌洗液中发现卡氏肺孢子虫的病例。他曾接受过针对不明原因间质性肺炎的类固醇治疗。三周后，他并发了肺炎链球菌引起的急性肺炎，同时在支气管肺泡灌洗液中检测到卡氏肺孢子虫。静脉输注青霉素并迅速减少类固醇用量后，肺部阴影和卡氏肺孢子虫均消失。对卡氏肺孢子虫的电子显微镜分析显示，卡氏肺孢子虫有大量管状扩张和内生现象，提示卡氏肺孢子虫在肺泡腔内生长。磷脂分析表明，卡氏肺孢子虫肺炎期间总磷脂含量短暂增加，提示卡氏肺孢子虫可影响表面活性物质代谢。
