肾移植术后合并卡氏肺孢子菌肺炎1例报告并文献复习  

Pneumocystis carinii pneumonia:a case report and literature review

作　　者：蒋旭琴[1] 胡晓文[1] 梅晓冬[1] 

机构地区：[1]安徽省立医院呼吸内科,安徽合肥230001

出　　处：《临床肺科杂志》2011年第11期1678-1680,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨肾移植术后卡氏肺孢子菌肺炎的临床。方法介绍1例确诊卡氏肺孢子菌肺炎并Ⅰ型呼吸衰竭的肾移植术后患者的临床资料并文献复习。结果患者肾移植术后免疫抑制剂持续治疗5月时,出现发热、咳嗽、咳痰、胸闷、气喘及呼吸困难,血液检查中性粒细胞比例增高,伴严重低氧血症,胸部CT显示两肺弥漫性渗出性病变伴间质改变,痰涂片找到卡氏肺孢子菌。予复方新诺明(SMZco)、甲基强的松龙、调整免疫抑制剂应用及其它支持对症治疗,15 d痊愈出院。结论肾移植术后合并卡氏肺孢子菌肺炎是常见机会性感染,及时诊断和治疗可取得满意的效果。Objective To explore the clinical characteristics,diagnosis and treatment of pneumocystis carinii pneumonia after renal transplantation.Method The data of a patient who was diagnosed pneumocystis carinii pneumonia with microbiological evidence was retrospectively analysed and the literature was reviewed.Results The patient developed fever,cough and dyspnea in the fifth month after renal transplantation.CT scanning demonstrated symmetric,apically distributed ground glass opacities with peripheral sparing.Blood gas analysis showed severe hypoxia.Peumocystis carinii was observed in the sputum smear.Treated with SMZ Co.plus steroid for two weeks,the patient＇s symptom relieved gradually and CT abnormality resolved.Conclusions Pneumocystis carinii is a common complication for renal transplantation and should be awared in the following-up.

关 键 词：器官移植 卡氏肺孢子菌肺炎 治疗 

分 类 号：R563.1[医药卫生—呼吸系统] R699.2[医药卫生—内科学]