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首页> 外文期刊>International Journal of Clinical and Experimental Pathology >Cryptogenic organizing pneumonia associated with invasive pulmonary aspergillosis: a case report and review of the literature
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Cryptogenic organizing pneumonia associated with invasive pulmonary aspergillosis: a case report and review of the literature

机译：与浸润性肺曲霉病相关的隐源性组织性肺炎：一例病例报告并文献复习

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Background: Concomitant occurrence of invasive pulmonary aspergillosis (IPA) with cryptogenic organizing pneumonia (COP) is scarce. Here, we report a case where COP was a presenting feature in a patient with diagnosed IPA, and review additional 58 COP patients reported in the literature from 1988 through 2013. Case outline: The study was reviewed and approved by the Institutional Ethics Committee of Shanghai Tenth People’s Hospital of Tongji University and was conducted in compliance with the Helsinki Declaration. Written informed consent was obtained from patient. A 56-year-old man presenting with productive cough for several weeks and unremitting high fever for a week was hospitalized with an initial clinical diagnosis of pneumonia, for which antibiotics were prescribed but did not work. Seeing that the condition progressed both clinically and radiographically, bronchoscopy, bronchoalveolar lavage and lung biopsy were performed, and the diagnosis of cryptogenic organizing pneumonia (COP) and invasive pulmonary aspergillosis (IPA) co-existence was made. Initially, the patient responded to steroid pulse therapy and voriconazole treatment, and his condition was partially improved. However, the patient’s condition deteriorated progressively 5 months after the disease onset and the patient died during the third admission due to respiratory failure and the adverse reactions of coriaceous hormone therapy. Conclusion: The diagnosis of cryptogenic organizing pneumonia (COP) and invasive pulmonary aspergillosis (IPA) co-occurrence depends on clinical, radiological and histological presentations. Similarities with other disease processes could lead to a delayed diagnosis or misdiagnosis. The present case suggests that clinicians should be alert to this disease in their clinical practices.
机译：背景：伴发隐源性组织性肺炎（COP）的侵袭性肺曲霉病（IPA）并发的情况很少。在这里，我们报道一例以COP为特征的确诊为IPA的患者，并回顾了1988年至2013年文献中报道的58例COP患者。病例概述：该研究由上海市机构伦理委员会审查和批准同济大学第十人民医院，是根据赫尔辛基宣言进行的。从患者获得书面知情同意。一名56岁的男子因咳嗽持续数周，持续高烧持续一周而住院，最初临床诊断为肺炎，对此患者开了抗生素但无效。鉴于该病在临床和影像学上均已进展，因此进行了支气管镜检查，支气管肺泡灌洗和肺活检，并诊断了隐源性组织性肺炎（COP）和浸润性肺曲霉病（IPA）并存。最初，患者对类固醇脉冲疗法和伏立康唑疗法有反应，病情得到部分改善。但是，患者的病情在疾病发作后5个月逐渐恶化，并且在第三次入院时由于呼吸衰竭和皮质激素治疗的不良反应而死亡。结论：隐源性组织性肺炎（COP）和浸润性肺曲霉病（IPA）并发的诊断取决于临床，影像学和组织学表现。与其他疾病过程的相似之处可能导致诊断或误诊延迟。本案建议临床医生在其临床实践中应警惕这种疾病。

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