肺囊蟲肺炎

10.6666/ClinMed.202005_85(5).0052

唐振育；陳夙容

肺囊蟲肺炎（Pneumocystis jirovecii） ； 伺機性感染（opportunistic infection） ； 免疫低下（immunocompromised status）

臨床醫學月刊

85卷5期（2020 / 05 / 29）

280 - 285

繁體中文

肺囊蟲肺炎是由人類肺囊蟲所引起的肺部伺機性感染，好發於愛滋病、血液惡性疾病、器官移植等免疫低下的病患，臨床上可能會表現出發燒、呼吸困難，一旦得到死亡率極高，所以針對高危險族群需要適當的抗生素預防，X光和胸部電腦斷層是常用的臨床檢查工具，但是肺囊蟲肺炎的診斷需要透過支氣管肺泡刷洗檢查或痰液誘導取得呼吸道檢體去染色得知，確立診斷後的第 一線抗生素治療以美坐磺胺曲美普林（trimethoprim/sulfamethoxazole）為主，及早針對愛滋病患的中重度肺炎給予類固醇可以有所幫助，隨著新的抗生素發展，當病患無法承受美坐磺胺曲美普林的副作用或是治療失敗時，棘白菌素（echinocandin）是另一個可考慮的低副作用抗生素治療。

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