感染症学雑誌
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
症例
副腎皮質ステロイド,シクロスポリンA 投与中に肺結節影,血中(1→3)-β-D-グルカン高値を呈し,播種性ノカルジア症, ニューモシスチス肺炎の診断に至った1 例
原田 壮平畠山 修司北沢 貴利糸山 智太田 康男小池 和彦
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2009 年 83 巻 5 号 p. 538-543

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A 78-year-old man administered prednisolone and cyclosporin A for bullous pemphigoid and found in computed tomography (CT) to have a left-lung nodule was suspected of having a fungal infection due to elevated blood (1→3)-β-D-glucan. Despite empirical antifungal therapy, however, the nodule grew, followed by new nodules in both lungs. Disseminated nocardiosis was eventually diagnosed based on sputum, blood, and skin cultures growing Nocardia sp. Antinocardial treatment with imipenem/cilastatin and amikacin was started. The patient then developed pneumocystis pneumonia for which pentamidine was added. He had recovered completely when antimicrobial therapy was completed. A wide variety of microorganisms may infect patients with impaired cellular immunity, simultaneously involving multiple organisms in some cases. Definitive microbiological diagnosis with culture or biopsy specimens is therefore crucial for appropriate management.

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© 2009 社団法人 日本感染症学会
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