Anaphylactoid Purpura, Empyema without Bronchial Fistula and Contralateral Interstitial Pneumonia Developing after Pneumonectomy for Advanced Lung Cancer with Preoperative Adjuvant Therapy

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  • 補助療法後の肺摘除例におけるアナフィラクトイド紫斑病, 遅発性無瘻性膿胸及び対側間質性肺炎の発生に対する1考察

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Abstract

A 68-year-old man, who had undergone right pneumonectomy after 3 cycles of preoperative radiochemotherapy for bulky N2 lung cancer, was readmitted because of dyspnea and fever accompanied by anaphylactoid purpura and herpes zoster. Two months after his discharge with relatively good recovery, however, he developed empyema in the postoperative cavity unaccompanied by bronchial fistula, which was managed by thoracotomy. He also developed contralateral interstitial pneumonia. Successful steroid and antibiotic therapy resulted in improvement. In spite of careful tapering of steroids, his condition deteriorated and he eventually succumbed to both interstitial and MRSA pneumonia. Serologically he was positive for HB virus and antineutrophil cytoplasmic antigen (p-ANCA (+) , c-ANCA (-) ) . We strongly suspected these factors triggered the ultimately tragic outcome.

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