合併症のないＰｎｅｕｍｏｃｙｓｔｉｓ　ｃａｒｉｎｉｉ　ｐｎｅｕｍｏｎｉａの１成人剖検例

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  • An autopsy case of Pneumocystis carinii pneumonia without other lesions in an adult.

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In 1978 we had a case of a housewife who died of Pneumocystis carinii pneumonia shortly after the diagnosis was made, in spite of no contributory anamnesis except suffering from symptoms of suspected intraoral candidiasis for several years. This is its autopsy case, i. e., an autopsy case of Pneumocystis carinii pneumonia in an adult without any associated lesions in which a long-term administration of medicine was not observed.<br>Case: A 37-year-old housewife having 2 children, no past history except tonsillectomy.<br>The patient complained of leukoplasia of hypoglottis and itching of pharynx since 1974. She visited a local doctor and was treated under the tentative diagnosis of intraoral candidiasis several times for a short time. In June 1977 raucedo and dry cough began. In July 1978, she developed anemia, leukocytosis and general fatigue. On September 23 she developed a fever of 38°C, cough, sputum and progressive dyspnea and was hospitalized on September 28. Complete blood count revealed slight anemia and the number of lymphocyte became 70% of 29700 white blood cell count. A chest roentgenogram showed the diffuse fine interstitial clouding over the entire lung and hilar swelling of both sides. A tentative diagnosis including leukemia, malignant lymphoma, interstitial pneumonitis and tuberculosis was made, but she died of respiratory insufficiency on the 14th hospital day.<br>The autopsy revealed the following findings. Lung appeared parenchymal organ and least pneumatic. The peribronchial and hilar lymphnodes were moderately enlarged. There were much eosinophilic masses and cysts of Pneumocystis carinii in alveoli and a moderate infiltration of plasmocytes, lymphocytes and leukocytes were present in alveolar septa. Lymph node was in sinus catarrh state and atypical lymphocytes were not present. Other malignant diseases were not found in bone marrow, spleen and other organs. Pneumocystis carinii pneumonia was only a chief lesion.<br>Acquired immunodeficiency was suggested by a negative skin test of P. P. D., Candida, relative reduction of T-cell, no increase in immunoglobulin and suppression of cold agglutinin test, however, the cause remained unknown.

収録刊行物

  • 医療

    医療 41 (10), 882-885, 1987

    一般社団法人 国立医療学会

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