嗜酸性粒细胞增多综合征误诊为急性血行播散性肺结核一例的临床综合分析

Hypereosinophic syndrome misdiagnosed as acute military tuberculosis： a case with literature review

临床中血行播散性肺结核易与多种疾病相混淆，笔者整理了1例嗜酸性粒细胞增多综合征误诊为急性血行播散性肺结核的病案，并对诊治过程中的专家讨论意见进行了归纳，该病例误诊的主要原因为患者胸部影像学表现为双肺弥漫性栗粒结节。然而，患者无发热，且全身皮疹严重，血常规示嗜酸性粒细胞增多长达6个月，糖皮质激素治疗有效，最终诊断为嗜酸性粒细胞增多综合征。继而进行文献复习，以期提高临床医师对表现为双肺粟粒结节影疾病的诊断水平。

Acute military tuberculosis is easy to be confused with many types of diseases. A case of hypere- osinophic syndrome misdiagnosed as military tuberculosis is reported and the consultant opinions during the diagnos- tic procedure are presented. Misdiagnosis was due to manifestation with military nodules in both lung fields in this case. However, diagnosis of hypereosinophic syndrome was finally established based on evidences as the follows： 1） lack of fever; 2） a developed skin rash; 3） increased numbers of eosinophils in the blood for more than 6 months; 4） good response to corticosteroid. The aim is to improve the diagnostic level focusing on such diseases with litera- tures review.