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題名 | Pyogenic Lung Abscess in a Patient with Wegener's Granulomatosis: A Case Report=韋格納肉芽腫合併肺膿瘍:病例報告 |
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作者 | 沈聲燁; 吳健樑; 劉洪彰; 曾岐元; | 書刊名 | 胸腔醫學 |
卷期 | 26:4 2011.08[民100.08] |
頁次 | 頁195-201 |
分類號 | 415.699 |
關鍵詞 | 肺膿瘍; 韋格納氏肉芽腫; Methicillin抗藥性金黃色葡萄球菌; Lung abscess; Wegener's granulomatosis; Methicillin-resistant Staphylococcus aureus; |
語文 | 英文(English) |
中文摘要 | 韋格納肉芽腫是一種影響多重器官的漸進性自體免疫血管炎。在肺部可以看到各式各樣的表現。因為病患需要使用免疫抑制劑作治療,是感染的高危險群,特別容易有肺炎產生。一個52歲的女性病患,肺部兩側有數個厚壁開洞,診斷為韋格納肉芽腫,對高劑量類固醇及cyclophosphamide反應良好,之後持續用低劑量類固醇及azathioprine治療。診斷後八個月發燒並在原本開洞處呈現多個air-fluid level。支氣管肺泡沖洗液培養出Methicillin抗藥性金黃色葡萄球菌,經抗生素治療後顯著改善。這讓我們了解在韋格納肉芽腫病患的肺部影像必須仔細鑑別診斷是疾病原本表現還是續發性感染發生。 |
英文摘要 | Wegener's granulomatosis is a progressive autoimmune vasculitis affecting multiple systems, and a wide variety of lesions may be seen in the lung. Because the disease is treated with immunosuppressants, patients are also at high risk of infection, particularly pneumonia. A 52-year-old woman with bilateral cavitating lung lesions was diagnosed with Wegener's granulomatosis. Her disease responded well to high-dose steroids and cyclophosphamide, after which she was maintained with azathioprine and low-dose prednisolone. Eight months after diagnosis, she presented with fever, and her chest x-ray showed air-fluid levels in residual cavitary lesions. Methicillin-resistant Staphylococcus aureus was cultured from the bronchoalveolar lavage fluid. With treatment, the patient recovered from the lung abscesses. A careful review of lung imaging studies is essential to distinguish between underlying Wegener's granulomatosis lung lesions and superimposed infection. |
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