第10巻 2014年4月　第2号

■症例報告

特発性肺線維症の急性増悪と肺結核とを同時発症した1例
長山　美貴恵, 齋藤　好信, 林　宏紀, 國保　成暁, 吾妻　安良太, 弦間　昭彦
日本医科大学内科学（呼吸器内科）

A Case of Simultaneous Onset of Acute Exacerbation of Idiopathic Pulmonary Fibrosis and Pulmonary Tuberculosis
Mikie Nagayama, Yoshinobu Saito, Hiroki Hayashi, Nariaki Kokuho, Arata Azuma and Akihiko Gemma
Department of Respiratory Medicine, Nippon Medical School

An 81-year-old man with idiopathic pulmonary fibrosis (IPF) came to our hospital with symptoms of fever and worsening dyspnea. We diagnosed an acute exacerbation of IPF (AE-IPF) on the basis of the findings of high-resolution computed tomography of the chest and thus started steroid therapy. However, we detected Mycobacterium tuberculosis in the sputum and concluded that pulmonary tuberculosis coexisted with AE-IPF. Because high-resolution computed tomography showed circumscribed consolidation in S¹⁰ of the left lung, we suspected that the consolidation was the focus of the tuberculosis. We started treatment of the pulmonary tuberculosis with antituberculous drugs; however, we were unable to control the AE-IPF, and the patient died. Interpreting the imaging findings of infection is difficult, particularly in cases of AE-IPF, which is associated with consolidation and may coexist with infection. The frequency of tuberculosis was higher in patients with IPF than in the general population. In cases of AE-IPF caused by infection, screening sputum tests, including those for acid-fast bacteria, are useful.

日医大医会誌 2014; 10(2), 111-114

Key words
pulmonary tuberculosis, idiopathic pulmonary fibrosis, acute exacerbation

Correspondence to
Mikie Nagayama, Department of Respiratory Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：m-nagayama@nms.ac.jp

受付：2014年1月6日　受理：2014年2月20日