Kobashi Y, Kimura M, Tano Y, Matsushima T
Department of Internal Medicine (II), Kawasai Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Feb;34(2):210-5.
A 66-year-old man was admitted to the hospital due to a rapidly progressing interstitial shadow in both lower fields on a chest roentgenogram taken on November 30 1993. The diagnosis was idiopathic interstitial pneumonia. A corticosteroid and a neutrophil elastase inhibitor were administered and the interstitial shadow resolved. A new infiltration shadow appeared in the right upper lung field one and a half months after the start of steroid therapy. This shadow gradually grew and Aspergillus fumigatus was detected in sputum cultures. In spite of treatment with FCZ+5-FC and 5-FC+AMPH, the abnormal shadow increased in size and mixed with the cavity, and the patient died of respiratory failure, with a pneumothorax caused by ruptures of the cavity formed by CNPA. The clinical and radiological course were considered to the indicative of chronic necrotizing pulmonary aspergillosis, which was described by Binder et al. in 1982.
一名66岁男性因1993年11月30日胸部X线片显示双下肺野迅速进展的间质性阴影而入院。诊断为特发性间质性肺炎。给予皮质类固醇和中性粒细胞弹性蛋白酶抑制剂治疗后，间质性阴影消退。在开始类固醇治疗一个半月后，右上肺野出现新的浸润阴影。该阴影逐渐增大，痰培养检测到烟曲霉。尽管使用氟康唑+5-氟胞嘧啶和5-氟胞嘧啶+两性霉素B治疗，异常阴影仍增大并与空洞融合，患者死于呼吸衰竭，死于由慢性坏死性肺曲霉病形成的空洞破裂导致的气胸。临床和放射学病程被认为提示慢性坏死性肺曲霉病，该病由Binder等人于1982年描述。
