Tuberculosis and Respiratory Diseases

  • 제68권2호
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  • Pages.97-100
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  • 2010
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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후천성면역결핍증후군 환자에게 급성 호산구성 폐렴 양상을 보인 폐포자충 폐렴 1예

A Case of Pneumocystis Pneumonia Mimicking Acute Eosinophilic Pneumonia in a Patient with AIDS

  • 이보라 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 김현국 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 박이내 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 최상봉 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 정훈 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이현경 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이성순 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이영민 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이혁표 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 최수전 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 염호기 (인제대학교 의과대학 서울백병원 내과학교실)
  • Lee, Bo-Ra (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kim, Hyun-Kook (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Park, I-Nae (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Choi, Sang-Bong (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Jung, Hoon (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyun-Kyung (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Sung-Soon (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Young-Min (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyuk-Pyo (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Choi, Soo-Jeon (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Yum, Ho-Kee (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine)
  • 투고 : 2009.10.09
  • 심사 : 2009.12.15
  • 발행 : 2010.02.28
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초록

A 73-year-old man was admitted with a sudden onset of dyspnea. He had never smoked. The chest radiograph and computed tomography revealed bilateral ground glass opacity and an enlarging perihilar consolidation with lymphadenopathies. There was a higher percentage of eosinophils (72%) in the bronchoalveolar lavage fluid (BALF) than normal. The patient was diagnosed with acute eosinophilic pneumonia and managed with steroid. Pneumocystis pneumonia (PCP) was diagnosed by an examination of the BALF, and the patient was treated with trimethoprim-sulphamethoxazole. The patient tested positive to the HIV antibody and the peripheral blood CD-4 positive lymphocyte count was only $33/{\mu}L$. The percentage of eosinophils in the BALF can increase in some cases of PCP that is complicated with AIDS. Only a few cases of eosinophilic pneumonia associated with PCP pneumonia have been reported in patients with AIDS but there are no case reports in Korea. This case highlights the need to consider PCP when the percentage of eosinophils in the BALF is elevated.

키워드

참고문헌

  1. Sadaghdar H, Huang ZB, Eden E. Correlation of bronchoalveolar lavage findings to severity of Pneumocystis carinii pneumonia in AIDS: evidence for the development of high-permeability pulmonary edema. Chest 1992;102:63-9. https://doi.org/10.1378/chest.102.1.63
  2. Thomas CF Jr, Limper AH. Pneumocystis pneumonia. N Engl J Med 2004;350:2487-98. https://doi.org/10.1056/NEJMra032588
  3. Nuesch R, Bellini C, Zimmerli W. Pneumocystis carinii pneumonia in human immunodeficiency virus (HIV)- positive and HIV-negative immunocompromised patients. Clin Infect Dis 1999;29:1519-23. https://doi.org/10.1086/313534
  4. Chung JS, Cho GJ, Kwak IS, Rha HY. A clinical study and prognostic factors for short-term survival of Pneumocystis carinii pneumonia in patients with AIDS. Korean J Med 1998;54:488-93.
  5. Jain P, Sandur S, Meli Y, Arroliga AC, Stoller JK, Mehta AC. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest 2004;125: 712-22. https://doi.org/10.1378/chest.125.2.712
  6. Tasaka S, Hasegawa N, Kobayashi S, Yamada W, Nishimura T, Takeuchi T, et al. Serum indicators for the diagnosis of Pneumocystis pneumonia. Chest 2007; 131:1173-80. https://doi.org/10.1378/chest.06-1467
  7. Cruciani M, Marcati P, Malena M, Bosco O, Serpelloni G, Mengoli C. Meta-analysis of diagnostic procedures for Pneumocystis carinii pneumonia in HIV-1-infected patients. Eur Respir J 2002;20:982-9. https://doi.org/10.1183/09031936.02.01372002
  8. Smith RL, el-Sadr WM, Lewis M. Correlation of bronchoalveolar lavage cell populations with clinical severity of Pneumocystis carinii pneumonia. Chest 1988; 93:60-4. https://doi.org/10.1378/chest.93.1.60
  9. Itoh M, Nakamura H, Nemoto K, Komiyama M, Hatao H, Shimizudani N, et al. A case of AIDS-complicated lung infection mimicking acute eosinophilic pneumonia. Nihon Kokyuki Gakkai Zasshi 2006;44:589-94.
  10. Jeong YJ, Kim KI, Seo IJ, Lee CH, Lee KN, Kim KN, et al. Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview. Radiographics 2007;27:617-37; discussion 637-9. https://doi.org/10.1148/rg.273065051
  11. Fleury-Feith J, Van Nhieu JT, Picard C, Escudier E, Bernaudin JF. Bronchoalveolar lavage eosinophilia associated with Pneumocystis carinii pneumonitis in AIDS patients: comparative study with non-AIDS patients. Chest 1989;95:1198-201. https://doi.org/10.1378/chest.95.6.1198