临床误诊误治2017，Vol.30Issue(6)：1-4,4.DOI:10.3969/j.issn.1002-3429.2017.06.001
亚急性血行播散型肺结核并结核性脑膜炎及多发脑结核瘤一例误诊并文献复习
Misdiagnosis Analysis and a Literature Review of One Patient with Subacute Hematogenous Pulmonary Tuberculosis Combined with TBM and Multiple Brain Tuberculomas
牛莉娅 1葛向华 1李小月 1李保胜 1孙殿兴1
作者信息
- 1. 050082 石家庄,解放军白求恩国际和平医院传染肝病科
- 折叠
摘要
Abstract
Objective To investigate clinical features of subacute hematogenous pulmonary tuberculosis combined with tuberculous meningitis (TBM) and multiple brain tuberculomas in order to improve levels of diagnosis and treatment.Methods Clinical data of 1 patient with subacute hematogenous pulmonary tuberculosis combined with TBM and multiple brain tuberculomas was retrospectively analyzed.Results The patient was admitted for edema in facial surface and both lower extremities for 2 years, intermittent cough and fever for 3 months and hyperpyrexia for 1d.The patient had a history of chronic nephritic syndrome and long-term oral glucocorticoids.After admission, examinations such as routine blood test, lumbar puncture cerebrospinal fluid examination, chest CT and head MIR were performed, and subacute hematogenous pulmonary tuberculosis combined with TBM and multiple brain tuberculomas was confirmed.The patient was given glucocorticoids and anti-tuberculosis treatments, and then was discharged when the condition was stable.After discharge, the patient kept oral administration such as Isoniazid , Rifampicin, Pyrazinamide and Methylprednisolone.The patient's condition was stable without recurrence.and the patient was still followed up till now.Conclusion Subacute hematogenous pulmonary tuberculosis combined with TBM and multiple brain tuberculomas is rare, and early diagnosis and treatment can obviously improve the prognosis.关键词
脑膜炎/结核性/结核瘤/颅内/误诊/肺结核Key words
Meningitis,tuberculous/Tuberculoma,intracalvarium/Misdiagnosis/
Pulmonary tuberculosis分类
医药卫生引用本文复制引用
牛莉娅,葛向华,李小月,李保胜,孙殿兴..亚急性血行播散型肺结核并结核性脑膜炎及多发脑结核瘤一例误诊并文献复习[J].临床误诊误治,2017,30(6):1-4,4.
