克罗恩病并肠道真菌感染误诊讨论

Analysis of Misdiagnosis of Crohn's Disease with Intestinal Fungal Infection

目的总结克罗恩病并肠道真菌感染的临床特点及误诊原因。方法对我院收治的误诊为溃疡性结肠炎的克罗恩病并肠道真菌感染1例的临床资料进行回顾性分析。结果本例因腹痛、腹泻7年余,加重3 d入院。曾就诊当地医院,诊断为溃疡性结肠炎,予美沙拉嗪肠溶片治疗,症状未见好转。入院后综合分析病史并完善胶囊内镜检查,明确诊断为克罗恩病,治疗期间体温升高,行便培养等相关检查,确诊合并肠道真菌感染,予美沙拉嗪缓释颗粒剂、甲泼尼龙及氟康唑等治疗后好转出院。随访6个月,病情未复发。结论克罗恩病并肠道真菌感染临床少见,仔细询问病史、全面分析检查结果有助于早期确诊,改善预后。

Objective To summarize the clinical characteristics and misdiagnosis causes of Crohn＇s disease with intestinal fungal infection. Methods A retrospective analysis was conducted on the clinical data of a case of Crohn＇s disease with intestinal fungal infection which was misdiagnosed as ulcerative colitis（ UC）. Results The patient was admitted to our hospital with abdominal pain and diarrhea for 7 years,which was aggravated 3 days before admission. The patient had visited the local hospital,and was misdiagnosed as UC and treated with Mesalazin Enteric-coated Tablets. However,the symptoms were not improved. After admission,on the basis of medical history and capsule endoscopy,the patient was diagnosed as Crohn＇s disease. During the treatment,the patient developed fever.The stool culture and other related tests confirmed Crohn＇s disease with intestinal fungal infections. The condition of the patient was improved and he was discharged home after treatment with Mesalazine SR Granules,methylprednisolone and fluconazole The patient was followed up for 6 months,and reported no recurrence. Conclusion Crohn＇s disease with intestinal fungal infection is rare in clinical settings,therefore,careful inquiry of medical history and comprehensive analysis of test results are useful for early diagnosis and improvement in prognosis.