Reports and documents review of a cases of acute on chronic liver failure complicated with pneumocystis carinii pneumonia

doi:10.3877/cma.j.issn.1674-1358.2019.01.016

Abstract

Abstract:

Objective

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).

Methods

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

Results

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.

Conclusion

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

Key words: Acute on chronic liver failure, Pneumocystis carinii pneumonia (PCP), Diagnosis, Treatment

Junchang Zhang, Yonggang Wang, Fang Lin, Jinsong Mu. Reports and documents review of a cases of acute on chronic liver failure complicated with pneumocystis carinii pneumonia[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(01): 81-84.

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References 22

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指标	9月19日	9月23日	9月26日	10月1日	10月5日	10月10日
体温（℃）	38.4	39.3	37.4	37.1	37.0	37.1
白细胞（× 10⁹/L）	21.4	26.4	14.7	14.2	10.7	9.2
中性粒细胞（%）	0.9	0.9	0.7	0.7	0.6	0.6
总胆红素（μmol/L）	359.6	389.1	374.2	424.3	416.2	395.6
凝血酶原活动度（%）	25.4	18.9	23.4	26.7	33.1	42.3
G试验（ng/L）	426.1	428.3	402.6	242.5	101.2	80.2
乳酸脱氢酶（U/L）	—	781.0	438.0	305.0	310.0	327.0
C-反应蛋白（mg/L）	112.8	76.6	70.3	41.6	32.1	25.6

指标	9月19日	9月23日	9月26日	10月1日	10月5日	10月10日
体温（℃）	38.4	39.3	37.4	37.1	37.0	37.1
白细胞（× 10⁹/L）	21.4	26.4	14.7	14.2	10.7	9.2
中性粒细胞（%）	0.9	0.9	0.7	0.7	0.6	0.6
总胆红素（μmol/L）	359.6	389.1	374.2	424.3	416.2	395.6
凝血酶原活动度（%）	25.4	18.9	23.4	26.7	33.1	42.3
G试验（ng/L）	426.1	428.3	402.6	242.5	101.2	80.2
乳酸脱氢酶（U/L）	—	781.0	438.0	305.0	310.0	327.0
C-反应蛋白（mg/L）	112.8	76.6	70.3	41.6	32.1	25.6

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