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Coinfection with Pulmonary Tuberculosis and Cryptococcosis in an Immunocompetent Individual-A Case Report

免疫健全的狀態下同時感染肺結核與隱球菌-病例報告

摘要


對一位免疫健全的病人而言,同時感染肺結核與隱球菌兩者是很罕見的,臨床上因兩者表現相似而更不易做出正確診斷。我們探討一位八十三歲男性病人初期表現為咳嗽、痰多與發燒兩週,除了慢性腎病第二期外,並沒有其他過去病史。胸部X光與電腦斷層檢查顯示左側上肺葉開洞與小葉中心結節病灶,痰液抗酸性染色與結合分枝桿菌聚合酶連鎖反應檢驗皆顯示陽性,血清隱球菌抗原測試亦為陽性,因而確診肺結核與肺部隱球菌感染。我們藉由回顧文獻,探討兩者對於肺部免疫機制的交互影響。

關鍵字

肺結核 隱球菌 免疫健全

並列摘要


Coinfection with pulmonary tuberculosis and Cryptococcus species in an immunocompetent patient is uncommon, and sometimes the diagnosis is missed as the two infections share similar clinical manifestations. We encountered an 83-year-old male patient with the initial presentation of cough, sputum production and fever for 2 weeks. He denied any other remarkable history or systemic disease except chronic kidney disease, stage 2. Chest radiograph and computed tomography revealed a left upper lobe cavitary lesion with centrilobular nodules. Pulmonary tuberculosis and cryptococcal pneumonia were verified by positive sputum acid-fast stain and tuberculosis polymerase chain reaction, along with a positive serum cryptococcal antigen test. We also reviewed the literature and discussed the mechanism of coinfection with pulmonary tuberculosis and cryptococcosis.

並列關鍵字

coinfection tuberculosis cryptococcosis

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