疑似肺结核合并结节病及曲霉菌病1例并文献复习

Suspected Pulmonary Tuberculosis Complicated with Sarcoidosis and Aspergillosis:a Case Report and Literature Review

结核病是威胁人类健康的主要公共卫生问题,目前我国每年新发肺结核患者约90万例[1]。结核病控制及治疗形式严峻,随着结核病诊断技术发展,临床医师对结核病、耐药结核及非结核分枝杆菌的认识有了很大提高。能够更早发现结核病及耐药结核病及非结核分枝杆菌病,将使患者得到及时诊治。但是结核病不是孤立的疾病,常常合并其他疾病,特别是影像学表现为多肺叶、多肺段、片状结节、空洞及纵膈淋巴结肿大的阴影,涉及多种疾病,给结核病诊断带来困难。结核病病理是以肉芽肿性炎及干酪坏死为主要表现疾病,结节病及曲霉菌感染病理也是肉芽肿性炎,临床表现相似,诊断困难,给临床医师带来困惑,本文结合1例疑似肺结核合并结节病及曲霉菌感染病例,了解诊治过程,并复习相关文献。

Tuberculosis is still a major public health problem threatening human health.At present,there are about 900000 new cases of tuberculosis in China every year.Tuberculosis control and treatment form is severe.With the development of tuberculosis diagnosis technology,clinicians'understanding of tuberculosis,drugresistant tuberculosis and nontuberculous mycobacteria has been greatly improved.They can detect tuberculosis and drug-resistant tuberculosis and non tuberculosis mycobacterium disease earlier,so that patients can get timely diagnosis and treatment.However,tuberculosis is not an isolated disease,often associated with other diseases,especially imaging manifestations of multiple lobes,multiple segments,patchy nodules,cavities and mediastinal lymph node enlargement shadow,involving a variety of diseases,which makes the diagnosis of tuberculosis difficult.Tuberculosis pathology is granulomatous inflammation and cheese necrosis as the main manifestations of disease,sarcoidosis and Aspergillus infection pathology is also granulomatous inflammation,clinical manifestations are similar,difficult to diagnose,bring confusion to clinicians,this paper combined with a suspected pulmonary tuberculosis with sarcoidosis and Aspergillus infection,to understand the diagnosis and treatment process,and review the relevant literature.