肺孢子菌肺炎的诊治体会

Diagnosis and treatment experiences of pneumocystis carinii pneumonia

目的了解肺孢子菌肺炎的临床表现及治疗,提高对疾病的认识及警惕性。方法对免疫缺陷患者临床资料进行分析,包括临床表现为不同程度发热、咳嗽、呼吸困难等非特异性症状,胸部CT表现为双肺从肺门开始的弥漫性网状结节样间质浸润,有时可呈毛玻璃状阴影,伴支气管充气像,同时从痰液及支气管肺泡灌洗液寻找病原学依据。结果 6例免疫缺陷患者合并上述临床表现及影像学表现均为肺孢子菌肺炎,给予口服复方磺胺甲基异恶唑治疗后治愈5例、死亡1例,治愈率83%。结论肺孢子菌是条件致病菌,免疫缺陷患者为肺子菌肺炎易感者,临床表现缺乏特异性。对免疫缺陷患者合并肺部感染者要考虑到肺孢子菌肺炎,并及早给予病原学检查,及早治疗,以提高肺孢子菌肺炎的治愈率,确诊依据为病原学结果。

Objective To investigate the clinical manifestation and treatment of pneumocystis carinii pneumonia, improve the awareness and vigilance of the disease. Methods The clinical data of immune compromised pa- tients were analyzed, including clinical manifestation of different degree of fever, cough, dyspnea and other non -specific symptoms, chest CT showed double lung from the beginning of hilum diffuse reticular nodular interstitial infiltrates, and sometimes was frosted glass shadow, with bronchial inflatable like, at the same time from sputum and bronchoalveolar lavage for pathogenic basis. Results 6 cases of immunodeficiency patients with the clinical and imaging manifestations were pneumocystis pneumonia, given oral Co trimoxazole after treatment, 5 cases were cured, 1 case died, the cure rate was 83%. Conclusions Pneumocystis is conditioned pathogen in immune compromised patients susceptible lung bacterial pneumonia, lack of specific clinical mani- festations of immune compromised patients with pulmonary infection to take into account the pneumocystis pneumonia, given early etiological examination, early treatment can improve the cure rate of pneumocystis ca- rinii pneumonia, which were confirmed by the etiology.