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目的提高对胺碘酮性肺炎、超鞭毛虫肺部感染及两病合并临床特点的认识。方法结合1例胺碘酮性肺炎合并超鞭毛虫肺部感染患者的临床资料及文献复习,对本病的临床表现、实验室检查、影像学、诊断和治疗进行分析。结果该患者在胺碘酮性肺炎基础上合并超鞭毛虫感染,临床症状为活动后胸闷、气急;实验室检查主要为肺弥散能力下降,支气管肺泡灌洗液中查到泡沫样巨噬细胞和超鞭毛虫;影像表现既有间质性改变又有肺泡渗出;因难以取得病理,诊断主要依赖临床;通过停用胺碘酮及应用抗原虫药物治疗超鞭毛虫感染,患者的临床症状明显缓解。结论胺碘酮性肺炎合并超鞭毛虫肺部感染非常罕见,其原因可能为胺碘酮性肺炎患者局部免疫功能下降,易并发肺部感染。
Objective To improve awareness of amiodarone pneumonia, superfluidian lung infection and clinical characteristics of two diseases. Methods The clinical data and literature review of 1 patient with pulmonary infection of amiodarone pneumonia complicated with superfamily flagellate were analyzed. The clinical manifestations, laboratory tests, imaging, diagnosis and treatment of this disease were analyzed. Results The patient was complicated with amiodarone pneumonia on the basis of the merger of Giardia lamblia infection. The clinical symptoms were chest tightness and shortness of breath after the activity. The laboratory tests mainly included the decline of the lung diffusibility, the finding of foamy macrophages in the bronchoalveolar lavage fluid and Super flagellates; imaging showed both interstitial changes and alveolar exudation; difficult to obtain pathology, the diagnosis depends mainly on clinical; by discontinuing amiodarone and the application of anti-protozoan drug treatment of flagellate infection, the patient’s clinical symptoms were significantly ease. Conclusions It is very rare that amiodarone pneumonia complicated with superfluidian lung infection may be caused by the decline of local immune function and the complicated pulmonary infection in patients with amiodarone pneumonia.