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題名 | Life-threatening Hypoxemia in a Young Adult: A Case Report of Idiopathic Acute Eosinophilic Pneumonia=患有危及生命之低血氧症的年輕人:急性嗜酸性白血球肺炎的病例報告 |
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作者 | 陳冠良; 張益銘; 彭萬誠; 簡志峰; Chen, Guan-liang; Chang, Yi-ming; Perng, Wann-cherng; Chian, Chih-feng; |
期刊 | 胸腔醫學 |
出版日期 | 20141000 |
卷期 | 29:5 2014.10[民103.10] |
頁次 | 頁317-322 |
分類號 | 415.46 |
語文 | eng |
關鍵詞 | 急性嗜酸性白血球肺炎; 低血氧; 支氣肺泡沖洗術; 嗜酸性白血球; 急性呼吸衰竭; Acute eosinophilic pneumonia; Hypoxemia; Bronchoalveolar lavage; Eosinophilia; Acute respiratory failure; |
中文摘要 | 不明原因的急性嗜酸性白血球肺炎是造成急性呼吸衰竭的疾病中一個罕見的原因,僅少數的個案報告,沒有明確的發生率,只有一篇研究報告183,000個在伊拉克的士兵中有發現18個病例。病患往往是出現了嗜酸性白血球增多症才有進一步確診,使治療從經驗性廣效抗生素治療轉變為類固醇治療。我們報告一個出現發燒和呼吸困難,且迅速進展至急性呼吸衰竭的22歲年輕人。病患在確診前一週接受hydrocortisone 200 mg/day,治療後症狀獲得戲劇性的改善,且在三天內即移除氣管內管。初始的胸部X光片和電腦斷層顯示肺部雙側多發性毛玻璃樣斑塊陰影。出現症狀的第10天後發展出嗜酸性白血球增多(15%),且支氣管肺泡沖洗術發現嗜酸性白血球百分比增加(37%)。在本個案並沒有發現會造成肺嗜酸性白血球增多的誘發因子,所以診斷為原因不明的急性嗜酸性白血球肺炎。患者於二週內逐漸恢復正常功能,症狀到目前為止並未復發。 |
英文摘要 | Idiopathic acute eosinophilic pneumonia is a rare cause of acute respiratory failure; studies are limited to case reports, and there is no definite incidence. One study reported 18 cases among 183,000 soldiers in or near Iraq. Diagnosis would lead to a change from empirical broad-spectrum antibiotic treatment to corticosteroid therapy, but the diagnosis is always delayed until the presentation of eosinophilia. We report a 22-year-old male who developed fever and breathlessness with rapid progression to acute respiratory failure. This patient received hydrocortisone 200 mg/day 1 week before the confirmatory diagnosis, and dramatically improved to the point of extubation within 3 days. Initial radiograph and computed tomography of the chest showed multiple ground-glass opacities in the bilateral lungs. Eosinophilia (15%) developed on the 10^(th) day, and bronchoalveolar lavage fluid revealed an elevated percentage of eosinophils (37%). No triggering agent that would have induced pulmonary eosinophilia was found in this case, so idiopathic acute eosinophilic pneumonia was diagnosed. The patient gradually recovered to normal activity within 2 weeks. No relapse of symptoms was seen up to this writing. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。