- 期刊
在尿毒症患者以濾出性肋膜積液表現之肋膜隱球菌感染－病例報告
Transudative Pleural Cryptococcal Infection in a Uremic Patient: A Case Report
摘要
目的：隱球菌感染是一種伺機性感染，易於免疫力缺乏族群如ESRD，HIV等病人身上發現。臨床上常見於肺部感染，嚴重者則影響中樞神經系統，本案例是屬於肺部瀰漫性感染，但未曾感染中樞神經系統。而本篇文章的目的，是在於提醒讀者，隱球菌感染病人的肋膜積液，是有可能以濾出液為表現。本案例報告是一篇以濾出性肋膜積液及肺部結節為表現的新型隱球菌感染之報告。病例報告：一位67歲男性，因咳嗽伴隨黃痰一週入院，胸部x光檢查發現左上肺結節與兩側肋膜積液，且此濾出性肋膜積液（transudate）的細菌培養結果，證實為新型隱球菌感染。經住院給與抗黴菌藥物治療後，胸部x光有大幅改善並順利出院於門診繼續追蹤治療。結論：以濾出性肋膜積液為表現之隱球菌感染的個案屬於相當少見，但值得重視。
並列摘要
Objective: Cryptococcus neoformans is a type of opportunistic pathogen commonly seen in immuno-compromised patients such as those with ESRD and HIV. The infections normally occur in the lung and may be disseminated to CNS region in more serious cases. Our case had disseminated lung infection without CNS infection. This case report aimed to remind that Cryptococcus neoformans infected patient may present with transudative pleural effusion. Case Report: A 67-year-old man was admitted to our hospital due to coughing with yellow sputum that persisted for a week. CXR (chest X-ray) revealed left upper lobe nodules and bilateral pleural effusion. Bacteria culture of the transudate of the pleural effusion turned out to be Cryptococcus neoformans positive. After treating with antifungal agents during hospitalization, the X-ray image showed major improvement; he was discharged and the treatment continued at the outpatient clinic. Conclusion: Cryptococcus neoformans infection in transudate is rare but the possibility should not be ignored.
延伸閱讀
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