Klebsiella Pneumoniae in Diffuse Panbronchiolitis

肺炎克雷伯菌在瀰漫性泛細支氣管炎的角色及處置－病例報告

林慧琼(Hwee-Kheng Lim) ； 洪紹庭(Sho-Ting Hung) ； 李士毅(Shih-Yi Lee)

《內科學誌》 31卷6期 (2020/12) Pp. 432-436

https://doi.org/10.6314/JIMT.202012_31(6).07

摘要

Diffuse panbronchiolitis (DPB) is a chronic, idiopathic, rare but lethal inflammatory airway disease resulting in distal airway dilation, obstructive lung disease, hypoxemia, and increased in the susceptibility of bacteria colonization. The case reports that a patient with destructive lung gets pneumonia by Klebsiella pneumoniae cured by bactericidal antibiotics, but K. pneumoniae in the airway is eradicated with erythromycin, which therefore highlights not only the importance to the testing for DPB in suspicious patients, but also the therapeutic strategies in managing DPB with K. pneumoniae in the airways.

關鍵字

Klebsiella pneumoniae ； Panbronchiolitis

並列摘要

瀰漫性泛細支氣管炎（Diffuse panbronchiolitis, DPB）是一種慢性，特發性，罕見但會致命的發炎性呼吸道疾病。瀰漫性泛細支氣管炎可導致廣泛性遠端細支氣管擴張，阻塞性肺疾病，低氧血症和細菌定植敏感性增加。本病例報告了一位瀰漫性泛細支氣管炎患者，殺菌性抗生素治癒了病人的肺炎克雷伯菌（Klebsiella pneumoniae, K. pneumoniae）導致的肺炎，但仍需要紅黴素來根除患者已被破壞肺部內的肺炎克雷伯菌菌落。因此，本病例不但指出了瀰漫性泛細支氣管炎的臨床診斷特徵，也提出針對肺炎克雷伯菌在瀰漫性泛細支氣管炎患者的治療策略。