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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of Swyer-James syndrome requiring surgical therapy because of recurrent pneumonia

Sayuri Hirookaa  Keisuke Kojimaa  Shinichiro Okamotoa  Toyohisa Irikia  Aiko Masunagaa  Yasuomi Ohbab  Makoto Suzukib  Hirotsugu Kohrogia 

aDepartment of Respiratory Medicine, Kumamoto University Hospital
bDepartment of Thoracic Surgery, Kumamoto University Hospital

ABSTRACT

A 25-year-old woman was admitted to our hospital because of recurrent pneumonia of the left upper lobe. Previous chest radiographs showed increased radiolucency of the left upper and middle lung fields, and pulmonary ventilation and perfusion scintigraphy at admission showed markedly decreased ventilation and perfusion in the left upper lobe. We diagnosed Swyer-James syndrome on the basis of these findings. Intravenous antibiotics failed to adequately improve the pneumonia; therefore, we performed a left upper lobectomy. Pathological findings of the resected lung showed bronchopneumonia with neutrophil infiltration and fibrosis, and a narrowing of the bronchus with endobronchial fibrosis containing islands of epithelial tissue or submucosal gland ducts. Pseudomonas aeruginosa was isolated from purulent pleural effusion and the resected lung tissue. We speculate that constrictive bronchitis and decreased perfusion caused the failure of antibiotic therapy.

KEYWORDS

Swyer-James syndrome  Surgical therapy  Pseudomonas infection 

Received 17 Mar 2014 / Accepted 21 May 2014

AJRS, 3(5): 708-712, 2014

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