课件：新型隐球菌是特发性阻塞性细支气管炎伴机化性肺炎的病因.ppt

, ,CASE REPORT,CN（cryptococcus neoformans）,as a cause of,BOOP (bronchiolitis obliterans organizing pneumonia),2019,-,1,CN（cryptococcus neoformans）,1、immunocompromised patients：,2、immunocompetent individuals：,systemic infections,localized pulmonary disease,2019,-,2,BOOP (bronchiolitis obliterans organizing pneumonia ),a rare severe form of pneumonitis caused by a variety of infectious and toxic agents or connective tissue diseases,2019,-,3,1、BOOP due to CN has very rarely been reported; 2、mostly in immunocompromised patients.,We report a case： CN-associated BOOP in an immunocompetent individual and discuss the diagnosis and treatment of this entity.,2019,-,4,*a 30-year old healthy Caucasian male,*10-day history of fever/chills and nonproductive cough,*denied any tobacco or illicit substance use,*a recent hunting trip to Canada,2019,-,5,oxygen saturation level was normal,a chest radiograph showed right upper lobe consolidation.,2019,-,6,oral levofloxacin,returned 3 days later with persistent fever, cough, and headache.,2019,-,7,hospitalized,intravenous ceftriaxone and azithromycin,A repeated chest radiograph/CT-scan:,bilateral upper and lower lobe consolidations and nodularity,2019,-,8,2019,-,9,image,image,2019,-,10,2019,-,11,2019,-,12,oral steroids fluconazole ,400mg/d, 3-month course,remained asymptomatic had no pulmonary infiltrates on chest radiograph.,9 months of follow-up,2019,-,13,Discussion,2019,-,14,1、observation alone without specific therapy 2、 treatment of symptomatic patients, particularly those with extensive disease on chest radiographs 3、high titers of serum cryptococcal antigen are believed to be a marker of systemic cryptococcal disease 4、antifungal therapy can probably be postponed with close observation for 23 months 5、oral fluconazole is an alternative,2019,-,15,6、BOOP：an inflammatory/fibrosing process involving the small airways that often results in progressive, irreversible obstructive pulmonary disease 7、pathogenesis：damage of the bronchiolar epithelial cells and recruitment of T lymphocytes and neutrophils to the site of injury; many cytokines and chemokines are secreted, perpetuating the inflammatory response and leading to fibroblast formation with obliteration of the airways,2019,-,16,5 case reports of an association between Cryptococcus and BOOP we report on a case of an immunocompetent young adult without history of previous lung disease who presented with a prolonged course of significant lung involvement and BOOP.,CN should be kept in mind as a possible etiology in patients who present with severe pneumonitis or bronchiolitis, even if they do not have AIDS or other immunosuppression, as this case illustrates.,2019,-,17,后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 资料仅供参考，实际情况实际分析,感谢您的观看和下载,The user can demonstrate on a projector or computer, or print the presentation and make it in