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1临床资料患者,男性,60岁,因肝移植术后3月余,发热伴咳嗽1 d入院。入院查体:T38.5℃,P 90次/min,R22次/min,BP137/82 mmHg,余查体未见明显异常。入院后完善相关化验检查,胸部CT示双肺间质性炎症。入院诊断为:(1)原位肝移植术后;(2)肺感染。患者肝移植术后3月余,继续口服他克莫司联合吗替麦考酚酸酯抗排斥治疗。患者肺部感染诊断明确,入院后无痰,拟行深部支气管取痰进行病原学检查,但考虑患者病情尚不稳定,未进行此项操作。患者老年,肝移植术后应用免疫抑制剂,结合胸部CT表现不排除特殊细菌及卡氏肺孢子虫感染,化验检查示巨细胞病毒阴性,给予
1 clinical data patients, men, 60 years old, more than 3 months after liver transplantation, fever and cough 1 d admission. Admission examination: T38.5 ℃, P90 times / min, R22 times / min, BP137 / 82 mmHg, the rest of the examination showed no obvious abnormalities. After admission to improve the relevant laboratory tests, chest CT showed interstitial lung inflammation. Admission diagnosed as: (1) orthotopic liver transplantation; (2) lung infection. More than 3 months after liver transplantation in patients with oral tacrolimus? Mycophenolate mofetil continued anti-rejection therapy. Diagnosis of lung infection in patients with clear, no sputum admission, the proposed line of deep bronchial sputum for etiological examination, but consider the patient's condition is not stable, did not carry out this operation. Elderly patients, the application of immunosuppressive agents after liver transplantation, combined with chest CT performance does not rule out special bacteria and Pneumocystis carinii infection, laboratory tests showed cytomegalovirus negative, given