治療経過中に両側肺に気胸を併発した原発性肺クリプトコックス症の1例  [in Japanese] A Case of Primary Pulmonary Cryptococcosis associated with Pneumothorax  [in Japanese]

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Abstract

治療経過中に両側肺に気胸を併発した原発性肺クリプトコックス症の1例を報告した. 症例は20歳・女性. 胸部単純X線写真で, 両側中下肺野の広範な浸潤影を認め, 経気管支肺生検によって原発性肺クリプトコックス症と診断した. amphotericin B及び flucytosine による治療を約2年半継続して, 左肺に気胸を併発した. 外科的に胸膜縫縮術および肺生検を施行した. 病理組織所見でマクロファージ内に一部が破壊されずに残存している <i>Cryptococcus</i> 認の菌体を確認した. 原発性肺クリプトコックス症の治療期間についても再考の必要があるものと思われた.

We report a case of primary pulmonary cryptococcosis. A 20-year-old woman was admitted to the hospital complaining of coughing, fever, and dyspnea on exertion. She had no underling disease or immunological abnormality. Chest X-ray film revealed bilateral diffuse infiltrative shadows, which were first believed to have been caused by a community-acquired pneumonia. Pulomonary cryptococcosis was diagnosed from the results of a transbronchial lung biopsy. After 2.5 years of anti-mycotic chemotherapy with amphotericin B and flucytosine, pneumothorax occurred in the left lung. Thoracotomy and open lung biopsy were done. Histological findings of the open lung biopsy specimens showed numerous broken cryptococcal organisms within alveolar macrophages. Diffuse fibrosis accompanied by multiple bullae may have punctured bullae or blebs and thus led to pneumothorax.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 33(5), 548-552, 1995-05-25

    The Japanese Respiratory Society

References:  12

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008107282
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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