胸腔病例（三六七）隱球菌肺炎

10.6666/ClinMed.202006_85(6).0068

張芝榕；沈佳儀；邱昭華

隱球菌肺炎（pulmonary cryptococcosis） ； 隱球菌（cryptococcus） ； 免疫力低下（immunocompromised） ； 伺機性感染（opportunistic infection）

臨床醫學月刊

85卷6期（2020 / 06 / 26）

371 - 376

繁體中文

隱球菌病（cryptococcosis）為一重要且常見的伺機性感染（opportunistic infection），感染多數發生在免疫力低下（immunocompromised）者，包括愛滋病患、血癌、接受器官移植、年長、酗酒、糖尿病等族群。免疫力健全（immunocompetent）的健康人感染的機率相對少，症狀也較輕微。隱球菌（Cryptococcus）存在於環境中，目前所知可對人類致病的種類有Cryptococcus neoformans（C. neoformans，新型隱球菌）和Cryptococcus gattii（C. gattii）。兩者感染途徑均為吸入遭受汙染、含隱球菌孢子（spores）的空氣微粒。隱球菌侵犯的器官首當其衝為肺部，若瀰漫至全身，則會造成中樞神經、皮膚、骨骼及血液等感染。本文為一患有糖尿病的中年男性，在三年一次健檢的胸部Ｘ光意外發現一3至4公分大小的肺腫塊，經電腦斷層引導胸部切片（CT-guided biopsy），證實為隱球菌肺炎（pulmonary cryptococcosis）。

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