在异性干细胞移植接受者的皮肤性肺囊 Jirovecii感染

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Updated: Jun 21, 2025

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Published on: March 1, 2024

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Nikhil Sood¹, Aniket Vadnerkar², Murali Kodali³

¹Department of Medicine, Banner Health, Gilbert, USA.

European journal of case reports in internal medicine

|July 10, 2024

概括

肺外肺炎 (PJP) 即使使用胺预防也可能发生. 这一病例突显出一种罕见的皮肤PJP感染,强调了免疫功能低下患者需要保持警的必要性.

科学领域:

医学真菌学医学真菌学
传染性疾病传染性疾病
免疫性受损的主体

背景情况:

肺囊 (Pneumocystis jirovecii) 是一种机会性真菌,会引起肺炎和肺外感染.
危险因素包括艾滋病毒,恶性瘤和低CD4计数 (<200细胞/μl).
使用trimethoprim-sulfamethoxazole (TMP-SMX) 的预防措施降低了PJP发生率.

研究的目的:

报告一种极为罕见的皮肤肺囊菌 (CPJ) 感染病例.
为突出诊断挑战的肺外PJP在免疫受损患者的预防.
为了强调二线PJP预防的局限性.

主要方法:

一位患有T细胞前淋巴细胞白血病的患者的病例报告,接受了全原干细胞移植.
患者接受了对PJP的胺预防.
诊断包括皮肤活检和对TMP-SMX的临床反应.

主要成果:

患者在接受胺预防期间出现了外肺PJP与皮肤干扰.
皮肤活检得不到结论,但结节在TMP-SMX治疗后消失了.
这代表了CPJ的罕见案例,二十年来没有报告过类似的病例.

结论:

肺外PJP,包括罕见的皮肤形式,可以发生尽管 pentamidine 预防.
TMP-SMX仍然是肺和肺外PJP的黄金标准治疗方法.
升高的Fungitell水平和PJP病史证明在免疫功能低下的患者中怀疑肺外疾病.

关键词:

皮肤性肺炎囊.干细胞移植是干细胞移植.

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