Pneumocystis Jiroveci Pneumonia with Adult Respiratory Distress Syndrome in an Immunocompetent Patient-A Case Report

肺囊蟲肺炎(PJP)主要是發生在免疫不全的病人，而且是一種威脅生命的傳染病，它常常發生在後天性免疫不全症候群（愛滋病）的病人身上，也可以發生在其他免疫不全的病人身上，但是不常發生於健康的人身上。在此，我們報告一名健康的49歲婦女在住院前兩週發生咳嗽有痰以及活動性呼吸急促的症狀。住院後上述症狀逐漸惡化並且進展到呼吸衰竭。她的胸部X光片揭示兩側肺葉擴散性的結節性浸潤。同樣的，在高解析度胸部電腦斷層(HRCT)也顯示彌漫性肺泡型浸潤。後來進行支氣管鏡及肺泡灌洗檢查，肺泡灌洗液抹片經由Giemsa's染色法証實是肺囊蟲的感染。病患在使用Trimethoprim-sulfamethoxazole治療之後症狀改進並且成功脫離呼吸器。在治療完成兩個月後追踨的胸部X光已接近正常。

關鍵字

肺囊蟲肺炎；免疫健全

並列摘要

Pneumocystis jiroveci pneumonia (PJP) is a life-threatening opportunistic infection which occurs in immunocompromised hosts, especially in patients with acquired immunodeficiency syndrome (AIDS), and increases in frequency in other immunocompromised patients, but it is very unusual in healthy people. We report a 49 -year-old woman who had been healthy until 2 weeks before admission. She suffered from productive cough with exertional dyspnea. The above symptoms progressed and respiratory failure developed after admission. Her chest radiographs revealed diffuse uniform nodular infiltration in both lungs. High resolution computed tomography (HRCT) showed diffuse alveolar densities and interstitial changes in both lower lungs. PJP was confirmed by Giemsa's stain of the bronchoalveolar lavage fluid retrieved via a bronchoscope. The symptoms improved and the patient was successfully weaned from the ventilator after treatment with trimethoprim-sulfamethoxazole. The chest radiographic infiltrations almost completely resolved 2 months after the treatment.

並列關鍵字

Pneumocystis jiroveci pneumonia PJP ； immunocompetent

國際替代計量

Pneumocystis Jiroveci Pneumonia with Adult Respiratory Distress Syndrome in an Immunocompetent Patient-A Case Report

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