1例免疫低下患者二次感染耶氏肺孢子菌肺炎的诊疗分析  

Diagnosis and Treatment of an Immunocompromised Patient with Secondary Infection of Pneumocystis jirovecii Pneumonia

作　　者：李蔚然 袁赛 王终平 王得宇 华毛 

机构地区：[1]青海大学临床医学院,青海 西宁 [2]河南省职工医院消化与内分泌科,河南 郑州

出　　处：《临床个性化医学》2025年第1期948-958,共11页Journal of Clinical Personalized Medicine

基　　金：青海省卫生健康委重点课题(编号:2020-wjzd-04)。

摘　　要：耶氏肺孢子菌肺炎是一种真菌感染,最常影响免疫功能低下的人群,严重时可危及生命。通常,高危患者是那些具有改变宿主免疫的基础疾病状态的患者,例如癌症、人类免疫缺陷病毒、移植受者或正在接受免疫抑制疗法和药物治疗的患者。本文报告了一例罕见的耶氏肺孢子菌感染病例,该病例发生在免疫功能低下的患者中,且在进行正规抗感染治疗一年后二次感染耶氏肺孢子菌肺炎且合并新型冠状病毒的感染,两次诊治过程中均给予抗感染、止咳化痰等治疗,患者发热、呼吸困难等症状最终好转并出院。本文通过复习有关资料,深入探讨了免疫低下患者耶氏肺孢子菌肺炎的临床特点及肺部影像学表现,着重分析反复感染的原因,以期提高临床认识。Pneumocystis jirovecii pneumonia is a fungal infection that most frequently affects individuals with compromised immune function and can be life-threatening in severe cases. Typically, high-risk patients are those with underlying disease conditions that modify host immunity, such as cancer, human immunodeficiency virus, transplant recipients, or patients who are undergoing immunosuppressive therapies and taking medications. This paper presents a rare instance of Pneumocystis jirovecii infection, which occurred in an immunosuppressed patient. The case was reinfected with pneumocystis jirovecii pneumonia and was complicated with novel coronavirus infection after one year of regular anti-infective treatment. Anti-infective treatment, along with cough and sputum reduction measures, were provided to the patient during both treatments. By reviewing the relevant data, the clinical characteristics and imaging findings of Pneumocystis jirovecii pneumonia in immunocompromised patients were discussed, and the causes of repeated infection were analyzed to enhance clinical understanding.

关 键 词：耶氏肺孢子菌肺炎 免疫功能低下 非HIV二次感染 

分 类 号：R73[医药卫生—肿瘤]