探讨慢加急性肝功能衰竭合并卡氏肺孢子菌肺炎的临床特征、影像学表现、诊断方法及治疗措施。

对1例慢加急性肝功能衰竭患者合并卡氏肺孢子菌肺炎的临床资料进行分析并复习相关文献。

该患者口服免疫抑制剂持续治疗2个月后出现发热、咳嗽、胸闷及呼吸困难，血液中性粒细胞比例增高，伴严重低氧血症，胸部CT显示两肺弥漫性渗出性病变伴毛玻璃样改变，支气管肺泡灌洗液涂片发现卡氏肺孢子菌。予复方新诺明、甲基强的松龙及其他支持对症治疗，并调整免疫抑制剂方案，26 d后痊愈出院。

慢加急性肝功能衰竭患者免疫抑制剂治疗过程中合并卡氏肺孢子菌肺炎为常见机会性感染，及时诊断和治疗可取得满意疗效。

To investigate the clinical features, imaging manifestations, diagnosis and treatment of a patient with acute on chronic liver failure (ACLF) complicated with pneumocystis carinii pneumonia (PCP).

The clinical data of an ACLF patient complicated with PCP were analyzed and related literature were reviewed.

This patient developed fever, cough, chest tightness and dyspnea, and increased proportion of neutrophils and severe hypoxemia occurred after 2 months continuous treatment with oral immunosuppressive agents. Chest CT showed diffused exudative lesions of two lungs with glass-like changes, and pneumocystis carinii was found in bronchoalveolar lavage fluid smears. After treated with SMZ Co, methylprednisolone and other supportive therapy, and adjusted immunosuppressant regimen, the patient was discharged 26 days later.

PCP is a common opportunistic infection during immunosuppressive therapy for patients with ACLF; satisfactory results could be obtained by timely diagnosis and treatment.