手術およびendobronchial Watanabe spigot挿入が功を奏したニュ－モシスチス肺炎後難治性気胸の1例

Pneumocystis Pneumonia-induced Pneumothorax Treated with Surgery and Insertion of an Endobronchial Watanabe Spigot；Report of a case

はじめに　ニューモシスチス肺炎（PCP）は，細胞性免疫が低下した患者で発症する亜急性肺炎である．PCP経過中に肺実質に囊胞性病変が出現することがあり，気胸を発症するとしばしば難治性である1）．われわれはPCP後難治性気胸に対し，手術およびendobronchial Watanabe spig‑ot（EWS：Novatech社，Grasse）挿入により気胸のコントロールができた症例を経験したので報告する．

Pneumothorax induced by Pneumocystis jirovecii （P. jirovecii） pneumonia is often refractory to treatment. A man in his 30’s who had malignant lymphoma and received chemotherapy developed P. jirovecii pneumonia. A month after treatment for pneumonia, he developed a secondary pneumothorax. Since drainage was not effective, he underwent right lower lobectomy and bulla resection. Air leakage stopped after surgery but recurred on postoperative day 5. Chest computed tomography showed a new bulla on his right lung. On postoperative day 15, we inserted an endobronchial Watanabe spigot （EWS）， and air leakage completely stopped.