1例伴有腰椎结核布鲁菌病患者的调查

Investigation on a case of brucellosis associated with tuberculosis of lumbar spine

目的对1例伴有腰椎结核的布鲁菌病(布病)患者进行追踪调查,提高布病诊断及鉴别诊断水平,从而减少漏诊和误诊。方法对该患者经影像学检查和血清学、病原学检查,证实其是否也是布病患者。结果该患者入院经临床症状、胸片、核磁共振等检查确诊为腰椎结核,按照该疾病治疗1周后患者症状加重,排查布病后确定为伴有腰椎结核布病患者。结论具有与牛羊及其附属物流行病学接触史的腰椎结核患者应尽早进行布病排查,以减少漏诊和误诊。

Objective To improve the level of brucellosis diagnosis and differential diagnosis by following and investigating a case of brucellosis with tuberculosis of lumbar spine,and to further reduce the missed diagnosis and misdiagnosis.Methods The case was examined by imaging,serology and etiology to determine whether or no patient with brucellosis.Results The inpatient was diagnosed as tuberculosis of lumbar spines by means of clinical symptoms,chest radiograph and MRI.The symptom was aggravated when the disease was treated for 1 week,and the patient was determined to,suffer from brucellosis associated with tuberculosis of lumbar spine after the investigation on brucellosis.Conclusion The patients with lumbar tuberculosis confirmed to have the history of epidemiological contact with cattle,sheep and their appendages should be screened for brucellosis at earliest convenience to reduce missed diagnosis and misdiagnosis.