在接受甲氨蝶呤、糖皮质激素和托珠单抗治疗的类风湿关节炎患者并发播散性肺结核、肺囊虫性肺炎和细菌性感染性休克的致命病例:尸检报告。

Case Reports in Rheumatology Pub Date : 2021-09-07 eCollection Date: 2021-01-01 DOI:10.1155/2021/7842049

Shin-Ichiro Ohmura, Ryuhei Ishihara, Ayaka Mitsui, Yoshiro Otsuki, Toshiaki Miyamoto

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引用次数: 0

摘要

最近，类风湿关节炎的治疗有了显著的改善，但增加了细菌和机会性感染的风险。在此，我们报告一例由广谱β-内酰胺酶产生的大肠杆菌引起的肾盂肾炎并发播散性肺结核、肺囊虫性肺炎和感染性休克的致命病例，该患者患有类风湿关节炎，接受甲氨蝶呤、糖皮质激素和托珠单抗治疗。尽管接受了强化治疗，但患者出现呼吸衰竭并在入院7天后死亡。尸检表明，肺结核是最终的死亡原因，而肾盂肾炎得到了控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report.

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Recently, treatment for rheumatoid arthritis has dramatically improved but increases the risk of bacterial and opportunistic infections. Herein, we report a fatal case of concurrent disseminated tuberculosis, pneumocystis pneumonia, and septic shock due to pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli in a patient with rheumatoid arthritis who received methotrexate, glucocorticoid, and tocilizumab. Despite undergoing intensive treatment, the patient developed respiratory failure and died after 7 days of admission. An autopsy indicated that pulmonary tuberculosis were the ultimate causes of death, while pyelonephritis was controlled.

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Case Reports in Rheumatology

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审稿时长

12 weeks