僧帽弁置換術後に発症したマイコプラズマ肺炎に対するシベレスタットナトリウムの使用経験

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A 71-year-old female patient received a replacement of mitral valve to treat valvular regurgitation. Her postoperative course was good. However, on day 3 after surgery, she developed respiratory dysfunction and her chest X-ray demonstrated ground glass opacity in both lungs. She remained intubated. We diagnosed respiratory distress associated with systemic inflammatory response syndrome caused by surgical invasion, and administered sivelestat sodium hydrate. On day 7 of drug treatment chest X-ray and respiratory function started improving, and she was extubated on day 19. Subsequent tests showed mycoplasma antibodies and elevated cold agglutination titers, which suggested acute interstitial pneumonitis caused by mycoplasma. We believe that early treatment with sivelestat sodium hydrate was effective against mycoplasma interstitial pneumonitis after mitral valve replacement.