摘要
目的比较艾滋病相关性卡氏肺孢子菌肺炎与非艾滋病相关性卡氏肺孢子菌肺炎的临床特征及辅助检查,以提高临床医师诊疗水平。方法收集2018年1月至2021年7月在某三甲医院确诊的卡氏肺孢子菌肺炎17例,按照不同基础疾病将病例分为艾滋病组(7例)与非艾滋病组(10例),比较两组病例的人口学特征、临床表现、实验室检查、病原学以及胸部CT影像学资料,并对各指标进行对比分析。结果艾滋病组病例平均年龄为37.7岁,且均为男性,非艾滋病组病例平均年龄为46.9岁,男性占70.0%。卡氏肺孢子菌肺炎感染时出现咳嗽、胸闷、喘憋的临床表现在艾滋病组均有发生,但在非艾滋病感染组有7例发生;非艾滋病组中病例均有发热,艾滋病组4例发热。8例病例通过纤维支气管镜行肺泡灌洗液检查查到卡氏肺孢子菌,2例经宏基因二代测序确诊。结论艾滋病合并卡氏肺孢子菌肺炎的病例均具有典型的肺部影像学特征及重症肺炎的临床表现;非艾滋病感染卡氏肺孢子菌肺炎病例多数合并风湿免疫系统疾病或恶性肿瘤,临床表现与疾病的严重程度不相符,因此临床医生应关注这类患者并及时行纤维支气管镜检查确诊。
Objective To compare the clinical features and the results of auxiliary tests among AIDS-associated and non-AIDS-associated Pneumocystis carinii pneumonia,so as to improve diagnostic and treatment capability of clinicians.Methods Seventeen cases of Pneumocystis carinii pneumonia diagnosed in a class A tertiary hospital from January 2018 to July 2021 were collected,and the cases were divided into AIDS group(7 cases)and non-AIDS group(10 cases)according to different underlying diseases.The demographic characteristics,clinical manifestations,laboratory tests,etiological results and chest CT imaging data of the two groups of cases were compared and each index was analyzed.Results The mean age of the cases in the AIDS group was 37.7 years old and all were male,while in the non-AIDS group the mean age was 46.9 years old and 70%were male.The clinical manifestations,including cough,chest tightness and wheezing occurred in all cases in the AIDS group and in 7 cases in the non-AIDS infection group during Pneumocystis carinii pneumonia.Fever was observed in all cases in the non-AIDS group and 4 cases in the AIDS group.Pneumocystis carinii was detected in 8 cases by fiber-optic bronchoscopic examination of broncho-alveolar lavage fluid and 2 cases were confirmed by metagenomic next generation sequencing.Conclusions All AIDS Cases complicated with Pneumocystis carinii pneumonia showed typical pulmonary imaging features and clinical manifestations of severe pneumonia.Most non-AIDS cases of Pneumocystis carinii pneumonia had rheumatic disease or malignancy,and the clinical presentations were inconsistent with the severity of the disease.Clinicians should pay attention to these patients and perform timely fiberoptic bronchoscopy to confirm the diagnosis.
作者
林怡如
李帆
丁国锋
Lin Yiru;Li Fan;Ding Guofeng(Department of Infectious Diseases,Binzhou Medical University Hospital,Binzhou 256600,China)
出处
《国际病毒学杂志》
2022年第2期129-132,共4页
International Journal of Virology
关键词
艾滋病
卡氏肺孢子菌肺炎
临床特征
Acquired immune deficiency syndrome
Pneumocystis carinii pneumonia
Clinical features
