1例肺吸虫病误诊结核病分析

Clinical analysis of a case with paragonimiasis misdiagnosed as tuberculosis

目的对1例肺吸虫病误诊为结核病病例进行分析,提出预防肺吸虫病误诊的方法。方法报告1例以皮下结节为主要临床表现,肺部CT显示典型"隧道样"病变的肺吸虫病被误诊为结核病长达1月,在抗结核治疗过程中又出现以肝脏损害为主要表现的消化道副作用的病例诊治过程。结果提示强化临床医师对肺吸虫病的认识,强化影像学医生对肺吸虫病肺部"隧道样"改变的认识,强化临床医师系统体检意识、分析血常规变化的能力,及时进行肺吸虫皮试,是减少误诊的办法。结论提高认识、强化"三基",可以避免肺吸虫病误诊。

Objective To analyze one case of paragonimiasis misdiagnosed as tuberculosi,and provide a method for preventing misdiagnosis. Methods One case was reported as a subclinical nodule as the main clinical manifestation. Pulmonary CT showed that the typical 'tunnel- like ' lesion of paragonimiasis was misdiagnosed as tuberculosis for up to 1 month. The anti-tuberculosis treatment process,there are cases of diagnosis and treatment of digestive tract side effects with liver damage as the main manifestation. Results To reduce the misdiagnosis,it suggests prompte intensive clinicians’ understanding of paragonimiasis,enhance imaging physicians’ understanding of'tunnel- like 'changes in the lungs of paragonimiasis,strengthen clinicians’ awareness of physical examination and analysis of blood routine changes,and receive timely lung fluke skin test. Conclusion Misdiagnosis of paragonimiasis will be avoid through understanding and strengthening the 'three basics'.