摘要
目的分析肺放线菌病的临床特征表现和误诊经验。方法回顾性分析2008年1月至2019年10月航天中心医院收治的16例肺放线菌患者的临床资料,分析肺放线菌病的临床特征、影像学表现、诊断、治疗及预后情况。结果16例肺放线菌患者中,发病部位:右肺上叶4例,占比25.0%;右肺中叶1例,占比6.3%;右肺下叶2例,占比2.5%;右肺中下叶2例,占比12.5%;左肺上叶5例,占比31.3%;左肺下叶2例,占比12.5%。临床表现:咳嗽16例,占比100.0%;咳痰16例,占比100.0%;咯血10例,占比62.5%;发热3例,占比18.8%;胸痛1例,占比6.3%。影像学表现:周围型11例,占比68.8%;中央型5例,占比31.3%。诊断情况:9例为肺楔形切除或肺叶切除后病理确诊;4例为支气管镜检查取活检病理确诊;3例为CT引导下肺穿刺活检病理确诊。影像学表现:16例患者镜下均见典型的放线菌菌团,且多伴有不同程度的肺组织炎症反应。治疗及预后情况:16例患者确诊后均于早期行足量足疗程青霉素治疗,病情均得到好转。结论肺放线菌病临床表现缺乏特异性,临床医师应引起高度重视,及时明确诊断,早期足量足疗程使用抗生素疗效显著。
Objective To analyze the clinical characteristics and misdiagnosis experience of pulmonary actinomycosis.Methods The clinical data of 16 patients with pulmonary actinomycosis admitted to Aerospace Central Hospital from January 2008 to October 2019 were retrospectively analyzed,the clinical characteristics,imaging manifestations,diagnosis,treatment and prognosis of pulmonary actinomycosis were analyzed.Results 16 patients with pulmonary actinomycetes,disease location:4 cases in the upper lobe of right pulmonary,accounting for 25.0%;1 case in the middle lobe of right pulmonary,accounting for 6.3%,2 cases in the inferior lobe of right pulmonary,accounting for 12.5%;2 cases in the middle and inferior lobe of right pulmonary,accounting for 12.5%;5 cases in the upper lobe of left pulmonary,accounting for 31.3%;2 cases in the inferior lobe of left pulmonary,accounting for 12.5%.Clinical manifestations:16 cases of cough,accounting for 100.0%;16 cases of sputum,accounting for 100.0%;10 cases of hemoptysis,accounting for 62.5%;3 cases of fever,accounting for 18.8%;and 1 case of chest pain,accounting for 6.25%.Imaging findings:11 cases of peripheral type,accounting for 68.8%;5 cases of central type,accounting for 31.3%.Diagnosis:9 cases were confirmed pathologically after pulmonary wedge resection or lobectomy;4 cases were confirmed pathologically by bronchoscopic biopsy;3 cases were con-firmed pathologically by CT-guided pulmonary biopsy.Imaging findings:a typical actinomycete colony was seen under microscope in 16 patients,and most of them are accompanied by different degrees of inflammatory reaction of pulmonary tissue.Treatment and prognosis:all 16 patients were treated with sufficient amount and course of penicillin in the early stage after diagnosis,and their condition was improved.Conclusion The clinical manifestations of pulmonary actinomycosis is lack of specificity,clinicians should be pay great attention to it,and make a clear diagnosis in time,ear-ly and full course of antibiotic treatment is effective.
作者
路伟强
窦学军
苗利彬
王志远
任德旺
LU Weiqiang;DOU Xueju;MIAO Libin;WANG Zhiyuan;REN Dewang(Department of Thoracic Surgery,Aerospace Central Hospital,Beijing,100049,China)
出处
《当代医学》
2024年第14期138-140,共3页
Contemporary Medicine
关键词
肺放线菌病
临床特征
诊断
误诊
Pulmonary actinomycosis
Clinical features
Diagnosis
Misdiagnosis