Fatal Pulmonary Co-infection with Pneumocystis and Cytomegalovirus in a Patient with Acquired Immunodeficiency Syndrome
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- Chuganji Eri
- Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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- Abe Toshikazu
- Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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- Kobayashi Hiroyuki
- Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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- Nakano Noriyuki
- Department of Diagnostic Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
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- Kanai Takao
- Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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- Ohara Gen
- Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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- Takayashiki Norio
- Department of Pathology, Mito Kyodo General Hospital, University of Tsukuba, Japan
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- Noguchi Masayuki
- Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, Japan
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- Morishita Yukio
- Department of Diagnostic Pathology, Tokyo Medical University Ibaraki Medical Center, Japan
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- Aoki Makoto
- Sakura Seiki Corp., Japan
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- Tokuda Yasuharu
- Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
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抄録
A 33-year-old homosexual Japanese man who admitted to having sex with men presented with a two-week history of dyspnea and fever. Chest imaging showed diffuse pulmonary frosted-glass-like shadows. A blood test revealed positive HIV antibodies with a CD4 cell count of 66/μL. Bronchoalveolar lavage identified pneumocystis. Although the patient exhibited a transient response to anti-pneumocystis treatment and mega-dose steroid pulse therapy, he eventually died from respiratory failure. An autopsy suggested massive cytomegalovirus and pneumocystis pneumonitis. The pulmonary co-infection with cytomegalovirus may have been worsened by the use of mega-dose steroids, and such therapy should be avoided in patients with a high HIV viral load and low CD4 count.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 53 (14), 1575-1578, 2014
一般社団法人 日本内科学会