Sylla G, Kullean N, Lafferre A, Mussard F, Rossi P
Clinique Pneumologique, Les Cadrans Solaires, Vence.
Rev Pneumol Clin. 1993;49(1):37-9.
We report a case of apparently isolated pleural Pneumocystis carinii infection in an AIDS patient under primary prophylaxis with pentamidine aerosols. Owing to the absence of the usual radiological signs and to negative broncho-alveolar lavages the diagnosis was difficult, and only pleural biopsy during thoracotomy made it possible. P. carinii cysts were demonstrated by Grocott's silver staining. Histological study of lung biopsy fragments only showed giant-cell granulomas of the foreign body type, with numerous calcifications. The occurrence of pneumothorax, ascribable in this patient to a minute and probably missed pulmonary focal lesion, was caused by the rupture of bullae remaining from an old tuberculosis.
我们报告一例在接受喷他脒气雾剂初级预防的艾滋病患者中出现的明显孤立性胸膜卡氏肺孢子虫感染病例。由于缺乏常见的放射学征象且支气管肺泡灌洗结果为阴性，诊断困难，仅通过开胸手术时的胸膜活检才得以确诊。通过格罗科特银染色显示出卡氏肺孢子虫囊肿。肺活检碎片的组织学研究仅显示异物型巨细胞肉芽肿，并伴有大量钙化。该患者发生气胸，可能是由于一个微小且可能被漏诊的肺部局灶性病变，是由陈旧性肺结核残留的肺大泡破裂所致。
