临床误诊误治2016，Vol.29Issue(9)：8-10,3.DOI:10.3969/j.issn.1002-3429.2016.09.004
非结核分枝杆菌肺病误诊讨论
A Study of Clinical Misdiagnosis of Non-tuberculous Mycobacteria Pulmonary Disease
林爱清 1杨效光 1刘国利 1李淑艳 1刘世政1
作者信息
- 1. 250013 济南，山东省胸科医院结核内一科
- 折叠
摘要
Abstract
Objective To analyze the clinical characteristics of nontuberculous mycobacteria pulmonary disease and its diagnostic and treatment methods. Methods One misdiagnosed case of non-tuberculous mycobacteria pulmonary disease was retrospectively analyzed, and relevant literatures were reviewed. Results The patient was admitted for 4 d of physical lung shadow. The patient had been diagnosed as having lung space-occupying lesions ( with /without lung cancer) by pulmo-nary CT in another hospital. She was admitted to our hospital to confirm diagnosis. Chest enhanced CT also showed lung space-occupying lesions ( with /without lung cancer) , and lung puncture was performed. Lung biopsy results were interstitial pneumonia, and the patient underwent Levofloxacin and Cephalosporin treatment. After 10 d of treatment, the third lung CT showed an enlargement of lesion. Meanwhile, sputum culture was positive for tuberculosis. Mycobacterium species identifica-tion of gene chip detection, suggested that it was NTM. The patient was diagnosed as having NTM lung disease, and under-went Rifabutin, Ethambutol and Azithromycin treatment. After 3 weeks of treatment, the forth lung CT showed that lung le-sions were significantly aborted, and then the patient was discharged from hospital. She was stable condition during follow-up for three months. Conclusion When normal clinical anti-infection therapy is inefficient and the imaging findings show that many lesion forms exist during the same period, including small patchy shadows, cavities, consolidation and bronchiectasis, the nontuberculous mycobacteria pulmonary disease is suggested, and sputum culture and strain identification should be under-taken as soon as possible in order to reduce missed diagnosis and misdiagnosis rates.关键词
非结核分枝杆菌/肺病/误诊/肺炎/结核,肺Key words
Non-tuberculous mycobacteria/Lung disease/Misdiagnosis/Pneumonia/Tuberculosis, pulmonary分类
医药卫生引用本文复制引用
林爱清,杨效光,刘国利,李淑艳,刘世政..非结核分枝杆菌肺病误诊讨论[J].临床误诊误治,2016,29(9):8-10,3.
