Abstract：
BACKGROUND: Reactivation of cytomegalovirus is more common in lymphoma patients undergoing hematopoietic stem cell transplantation, but reactivation of cytomegalovirus due to chemotherapy for lymphoma has rarely been reported. We report a case of a lymphoma patient with secondary pulmonary fungal infection and cytomegalovirus infection after chemotherapy, which ultimately led to organizing pneumonia.
METHODS: Percutaneous lung biopsy, Next Generation Sequencing (NGS).
RESULTS: NGS examination suggestive of cytomegalovirus infection, percutaneous lung biopsy suggests the presence of organizing pneumonia. The patient was discharged after a combination of antifungal and antiviral treatment with posaconazole, ganciclovir, and anti-inflammatory treatment with methylprednisolone.
CONCLUSIONS: In patients with lymphoma, one should be alert for fungal and viral infections of the lungs when lung related clinical manifestations occur. Patients with persistent unrelieved symptoms after treatment should undergo lung biopsy or bronchoscopy to obtain pathologic tissue for definitive diagnosis.
METHODS: Percutaneous lung biopsy, Next Generation Sequencing (NGS).
RESULTS: NGS examination suggestive of cytomegalovirus infection, percutaneous lung biopsy suggests the presence of organizing pneumonia. The patient was discharged after a combination of antifungal and antiviral treatment with posaconazole, ganciclovir, and anti-inflammatory treatment with methylprednisolone.
CONCLUSIONS: In patients with lymphoma, one should be alert for fungal and viral infections of the lungs when lung related clinical manifestations occur. Patients with persistent unrelieved symptoms after treatment should undergo lung biopsy or bronchoscopy to obtain pathologic tissue for definitive diagnosis.
摘要：
背景：巨细胞病毒的再激活在接受造血干细胞移植的淋巴瘤患者中更为常见，但淋巴瘤化疗导致巨细胞病毒再激活的报道很少。我们报告一例淋巴瘤患者化疗后继发肺部真菌感染和巨细胞病毒感染，最终导致了组织性肺炎。
方法：经皮肺活检，下一代测序(NGS)。
结果：NGS检查提示巨细胞病毒感染，经皮肺活检提示存在机化性肺炎。患者经抗真菌及抗病毒联合泊沙康唑治疗后出院,更昔洛韦,和甲基强的松龙的抗炎治疗。
结论：在淋巴瘤患者中，当出现肺部相关临床表现时，应警惕肺部真菌和病毒感染。治疗后症状持续未缓解的患者应进行肺活检或支气管镜检查以获得病理组织以明确诊断。
方法：经皮肺活检，下一代测序(NGS)。
结果：NGS检查提示巨细胞病毒感染，经皮肺活检提示存在机化性肺炎。患者经抗真菌及抗病毒联合泊沙康唑治疗后出院,更昔洛韦,和甲基强的松龙的抗炎治疗。
结论：在淋巴瘤患者中，当出现肺部相关临床表现时，应警惕肺部真菌和病毒感染。治疗后症状持续未缓解的患者应进行肺活检或支气管镜检查以获得病理组织以明确诊断。
