布鲁杆菌病误诊为炎性关节病3例报告及文献复习

Brucellosis misdiagnosed as arthritis: An analysis of 3 cases and literature review

目的分析布鲁杆菌病与风湿性疾病的鉴别要点和误诊原因。方法回顾2014年2月-2015年3月解放军第88医院收治的布鲁杆菌病3例资料并复习文献资料。结果布鲁杆菌病临床表现复杂,骨关节脊柱受累常见,可伴有多器官、多系统损害,容易误诊为强直性脊柱炎、滑膜炎、风湿热、血管炎等多种风湿性疾病。结论布鲁杆菌病易误诊为风湿性疾病,非感染科医师尤其需要加强对本病的认识,避免误诊误治。

Objective To analyze the distinctions between brucellosis and rheumatic diseases, and the causes of misdiagnosis of Brucellosis. Methods Clinical data about 3 patients with Brucellosis admitted to Chinese PLA 88 th Hospital from February 2014 to March 2015 were retrospectively analyzed and related literatures were reviewed. Results Brucellosis had complex clinical presentation, and always involved in bones, joints and spine, also complicated with multiple organ damage. It was often misdiagnosed as rheumatic disease, such as ankylosing spondylitis, synovitis and vasculitis, etc. Conclusion Differential diagnosis and epidemiological investigation are required for Brucellosis in case of misdiagnosing as rheumatic disease.