肺囊炎肺炎呈现与周围占主导地位的巩固和拉力支气管支气管切开症
Nobuhiro Fujishima1, Yoshihide Hioki1, Atsushi Yokoyama1
1Respiratory Medicine and Infectious Diseases, Oita University, Yufu, JPN.
Cureus
|July 29, 2024
概括
肺囊性肺炎 (PCP) 通常表现为上半叶地面玻璃不透明. 这一案例突显了PCP模仿其他肺部疾病的下叶巩固,成功地用trimethoprim-sulfamethoxazole治疗.
科学领域:
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
背景情况:
- 肺囊炎 (PCP) 肺炎 (PCP) 通常表现为分散的地面玻璃不透明度 (GGO),主要在上叶.
- 不典型的PCP表现可能会带来诊断挑战,可能会模仿其他间歇性肺部疾病.
研究的目的:
- 报告一种罕见的PCP病例,其成像发现模仿组织性肺炎或非特异性间歇性肺炎.
- 强调在异常肺结合症的差异诊断中考虑PCP的重要性,特别是在免疫受损患者中.
主要方法:
- 一份病例报告详细介绍了非典型PCP患者的临床表现,高分辨率计算机断层扫描 (HRCT) 发现和诊断工作.
- 在支气管泡洗液 (BAL) 中检测Pneumocystis jirovecii.
- 确认人体免疫缺陷病毒 (HIV) 感染,CD4+细胞数量较低.
主要成果:
- 患者在HRCT上表现出周围主导的巩固,引支气管和周围支气管血管在下半叶的加厚,这是PCP的一个不寻常的模式.
- 肺囊 (Pneumocystis jirovecii) 被确定为唯一的病原体.
- 该患者被诊断患有与艾滋病毒感染相关的PCP,并在三甲胺-硫甲醇治疗后完全消除了整合.
结论:
- PCP可以呈现异常的放射性发现,包括外围巩固和暗示有组织性或非特异性间歇性肺炎的特征.
- 医生应该保持高的PCP怀疑指数在患者有不明原因的肺透,即使HRCT的发现是不典型的.
- 及时诊断和治疗对于艾滋病毒相关PCP的良好结果至关重要.
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