胰腺、肺部和脑部的播散性隐球菌:病例报告。

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL
Hsu-En Cheng, Hong-Zen Yeh, Chi-Shun Yang, Sheng-Shun Yang, Szu-Chia Liao
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引用次数: 0

摘要

背景:隐球菌是一种通过从环境中吸入而获得的机会性感染,主要影响免疫系统受损的人。它通过肺组织时通常会导致肺炎。感染可通过血液传播到各个器官,导致中枢神经系统的脑膜炎或脑炎。据报道,播散性隐球菌可累及皮肤、肝脏、眼睛、淋巴结、骨髓、脾脏、肾脏和肠道,从而大大增加发病率和死亡率。然而,隐球菌累及胰腺的情况相对罕见,少数病例报告强调了严重的器官损害和高死亡率:在本病例报告中,我们介绍了一名 36 岁亚洲男子的病例,他因头痛和右眼视力模糊就诊 2 周。胸部计算机断层扫描发现,脑磁共振成像显示多发脑肿块,左下肺野也有肿块,胰腺尾部也有肿瘤。内镜超声引导下的细针活检和计算机断层扫描引导下的肺部活检确诊为播散性隐球菌感染,累及胰腺、肺部和大脑。抗真菌治疗后,患者的临床症状有所改善。此外,我们还发现抗粒细胞-巨噬细胞集落刺激因子抗体是该患者感染播散性隐球菌病的危险因素:结论:正如以往文献所强调的,播散性隐球菌病可能是一种潜在的致命疾病。然而,使用对比增强谐波内窥镜超声和内窥镜超声引导下活检进行早期诊断,并在本病例中进行及时治疗,可以改善预后并预防死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disseminated Cryptococcus over pancreas, lung, and brain: a case report.

Background: Cryptococcus is an opportunistic infection acquired through inhalation from the environment, primarily affecting individuals with compromised immune systems. It typically leads to pneumonia upon passing through lung tissue. The infection can disseminate to various organs via the bloodstream, resulting in meningitis or encephalitis in the central nervous system. Disseminated Cryptococcus has been reported to involve the skin, liver, eyes, lymph nodes, bone marrow, spleen, kidneys, and intestines, significantly increasing morbidity and mortality. However, pancreatic involvement in Cryptococcus is relatively rare, and a few case reports have highlighted severe organ damage and high mortality rates.

Case presentation: In this case report, we present the case of a 36-year-old Asian man who presented with a 2-week history of headaches and blurred vision in his right eye. Brain magnetic resonance imaging revealed multiple brain masses, along with a mass in the lower left lung field and a tumor in the pancreatic tail, as detected by chest computed tomography. Endoscopic ultrasound-guided fine needle biopsy and computed tomography-guided lung biopsy confirmed the diagnosis of disseminated cryptococcal infection involving the pancreas, lung, and brain. The patient's clinical condition improved following antifungal therapy. Additionally, we identified anti-granulocyte-macrophage colony-stimulating factor antibody as a risk factor for disseminated cryptococcal infection in this patient.

Conclusion: Disseminated cryptococcosis can be a potentially lethal condition, as highlighted by previous literature. However, early diagnosis using contrast-enhanced harmonic endoscopic ultrasound and endoscopic ultrasound-guided biopsies, as well as prompt treatment as demonstrated in our case, can improve outcomes and prevent mortality.

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来源期刊
Journal of Medical Case Reports
Journal of Medical Case Reports Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
436
期刊介绍: JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
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