肺放线菌病1例报道及误诊原因分析

Pulmonary a ctinomycosis： a case report and misdiagnosis analysis

目的探讨放线菌病的临床特征、影像学表现及误诊原因。方法报道l例胸型放线菌病，并结合文献，总结放线菌病的临床特征、影像学表现，对误诊原因进行系统分析。结果胸型放线菌病发病率低，临床医师认知较少，极容易误诊，主要引起误诊的原因为临床表现普通，影像学表现多样，放线菌标本取材困难，疗效判断周期长。为此，应该提高临床医师对本病的认识，同医技科室多交流，进行厌氧菌培养及特殊染色，提高诊断正确率，减少误诊。结论放线菌病是一种少见病，临床上容易误诊，如果能够做到早诊断并提高综合治疗方案，预后良好。

Objective To explore the clinical characteristics and imaging manifestations of actinomycosis and discuss the misdiagnosis reasons for actinomycosis. Methods Herein, this article described the case of 57 year-old patient that was misdiagnosed as pneumonia, and summarized the clinical characteristics and imaging manifestations of the actinomycosis, and then the reasons for misdiagnosis were analysised systematically. Results With a low incidence, actinomycosis was extremely easy to be misdiagnosed. As for the main causes of misdiagnosis, the common clinical symptoms, the varied imaging findings, it was difficult to get actinomyces specimen and needed long time to judge curative effect are all on the list. Therefore, clinician should make great efforts to get more knowledge about actinomycosis and communicate with medical laboratory for furthermore detecting techniques such as anaerobic bacteria culture and special dyeing, so that diagnostic accuracy could be improved and the misdiagnosis could be reduced. Conclusions As a rare disease, actinomycosis is easily to be misdiagnosed clinically. However, making a right diagnosis at early stage and implementing comprehensive therapy are benefit for the patients.