Kim J Y, Lim C M, Koh Y, Choe K H, Kim W S, Kim W D
Division of Respiratory Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Eur Respir J. 1997 Dec;10(12):2902-3. doi: 10.1183/09031936.97.10122902.
A 27 yr old man presented with productive cough, fever and manifestations of superior vena cava syndrome. He was an alcoholic but had been in good health until 3 days prior to admission. The physical examination, the chest radiograph and the results of the sputum culture were compatible with Klebsiella pneumoniae pneumonia of the right upper lobe. The superior vena cava scintigram using technetium-99m showed near total occlusion of the superior vena cava, while sputum cytology, chest computed tomography, and bronchoscopy were all negative for malignant aetiology. Antibiotic therapy brought about slow resolution of the pneumonia and also of the superior vena caval obstruction. The follow-up scintigram showed normalized venous flow of the superior vena cava. To our knowledge, this is the first case of superior vena cava syndrome developed in probable association with Klebsiella pneumoniae pneumonia.
一名27岁男性出现咳嗽、发热及上腔静脉综合征表现。他有酗酒史，但入院前3天一直身体健康。体格检查、胸部X线片及痰培养结果均符合右上叶肺炎克雷伯菌肺炎。使用锝-99m进行的上腔静脉闪烁扫描显示上腔静脉几乎完全阻塞，而痰细胞学检查、胸部计算机断层扫描及支气管镜检查均未发现恶性病因。抗生素治疗使肺炎及上腔静脉阻塞症状缓慢缓解。随访闪烁扫描显示上腔静脉血流恢复正常。据我们所知，这是首例可能与肺炎克雷伯菌肺炎相关的上腔静脉综合征病例。
