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題 名 | Multilobar Consolidation with Abscess Formation Caused by Legionella Pneumophila: An Unusual Chest Radiographic Presentation=嗜肺退伍軍人菌造成之多肺葉實質化合併膿瘍形成: 罕見之胸部X光表現 |
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作 者 | 張峰義; | 書刊名 | 微免與感染雜誌 |
卷 期 | 31:3 1998.09[民87.09] |
頁 次 | 頁200-202 |
分類號 | 415.2748 |
關鍵詞 | 嗜肺退伍軍人菌; 多肺葉實質化; 膿瘍; 胸部X光; Legionella pneumophila; Multilobar consolidation; Lung abscess; |
語 文 | 英文(English) |
中文摘要 | 52歲男性,主訴發燒、胸痛、咳嗽帶膿痰及咳血有4天之久。病人曾因慢性阻塞性 肺病合併急性病情惡化及心臟衰竭而在醫院住院達 11 天,病情穩定後於 5 天前出院。 住 院期間曾接受頭芽孢素( cephalosporin )及皮質類固醇治療, 病人過去病史包括酒精性 肝硬化及酒精性心肌病變。住院時胸部X光片發現肺兩側有多處病灶,如網球般大小,痰直 接免疫螢光染色和痰培養證實有血清型第 5 型嗜肺退伍軍人菌, 而退伍軍人病之血清學檢 查則為陰性。雖然該病人接受經靜脈紅黴素及 rifampin 治療,病人仍於七天後死亡。屍體 解剖發現兩側肺實質化合併膿瘍形成、肺水腫及肺鬱血。在免疫受抑制的病人,進行性擴大 的肺結節之鑑別診斷應包括一些機遇性致病原如黴菌、土壤絲菌以及退伍軍人菌所造成之感 染。 |
英文摘要 | A 52-year-old male had fever, pleuritic chest pain, cough with purulent sputum and hemoptysis for 4 days. The patient had underlying alcoholic cardiomyopathy, cirrhosis of the liver, chronic obstructive lung disease and underwent corticosteroids therapy. Chest radiograph showed round opacities bilaterally. Legionella pneumophila serogroup 5 was identified by direct fluorescent antibody staining and culture from the sputum. Despite intravenous erythromycin and rifampin therapy, he died on the 7th hospital day. The autopsy showed bilateral pulmonary consolidation with abscess formation. Legionnaires' disease should be included in the differential diagnosis if an immunosuppressed patient presents with multilobar opacities on chest radiograph. Specific tests for Legionnaires' disease should be performed. |
本系統中英文摘要資訊取自各篇刊載內容。