最后审阅: 18 九月 2021
最后更新: 26 一月 2021

小结

定义

病史和体格检查

其他诊断因素

  • 口咽念珠菌病
  • 复发性细菌性肺炎
  • 体重减轻
  • 症状持续时间较长(HIV 阳性患者
  • 症状发作迅速(HIV 阴性患者
  • 发热
  • 干咳
  • 呼吸困难
  • 乏力
  • 胸部检查正常
  • 心动过速
  • 呼吸急促或呼吸窘迫
  • 紫绀
  • 肺外表现
  • 胸膜炎性胸痛
  • 单侧呼吸音减弱

危险因素

  • CD4 细胞计数低于 200 cells/μl
  • 免疫功能受损状态
  • 长期使用糖皮质激素治疗
  • 之前曾罹患肺孢子菌肺炎

诊断性检查

首要检查

  • 胸部 X 线检查
  • 动脉血气
  • 血清 LDH 水平
  • 诱导痰

需考虑的检查

  • 肺部高分辨率 CT(HRCT)
  • 肺功能测试
  • 支气管镜和支气管肺泡灌洗 (BAL)
  • 活检

新兴检查

  • 聚合酶链反应 (PCR)
  • 血浆 S-腺苷蛋氨酸水平
  • 血清(1,3)-β-D-葡聚糖水平

治疗流程

撰稿人

作者

Alison Morris, MD, MS
Alison Morris

Professor of Medicine

Pulmonary, Allergy and Critical Care Medicine

University of Pittsburgh

Pittsburgh

PA

利益声明

AM is an author of a number of references cited in this topic.

Ioannis Konstantinidis, MD

Fellow

Pulmonary, Allergy and Critical Care Medicine

University of Pittsburgh

Pittsburgh

PA

利益声明

IK declares that he has no competing interests.

鸣谢

Dr Alison Morris and Dr Ioannis Konstantinidis would like to gratefully acknowledge Dr Eric Nolley and Dr Matthew Gingo, previous contributors to this topic.

利益声明

EN and MG declare that they have no competing interests.

同行评议者

Peter D. Walzer, MD, MSc

Associate Chief of Staff for Research

Cincinnati VA Medical Center

Professor of Medicine

University of Cincinnati

Cincinnati

OH

利益声明

PDW declares that he has no competing interests.

David Spencer, MBChB(UCT), MMed (Wits)

Specialist Physician and Consultant

Toga Laboratory and Kimera Consultants

Edenvale

Johannesburg

South Africa

利益声明

DS declares that he has no competing interests.

Graeme Meintjes, MBChB, MRCP, FCP, DipHIVMan

Infectious Diseases Physician

Institute of Infectious Diseases and Molecular Medicine

Faculty of Health Sciences

University of Cape Town

Observatory

South Africa

利益声明

GM declares that he has no competing interests.

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