临床误诊误治2018，Vol.31Issue(5)：1-4,4.DOI:10.3969/j.issn.1002-3429.2018.05.001
获得性免疫缺陷综合征合并肺孢子菌肺炎误诊为间质性肺疾病五例分析
Clinical Analysis of Five Cases of AIDS Complicated with Pneumocystis Carinii Pneumonia Misdiagnosed as Interstitial Lung Disease
摘要
Abstract
Objective To investigate the causes of misdiagnosis and preventive measures of AIDS complicated with Pneumocystis carinii pneumonia(PCP). Methods Clinical data of 5 patients with PCP misdiagnosed as intersti-tial lung disease (ILD) in our hospital were retrospectively analyzed. Results Of 5 patients,one was admitted to our hospital for cough,expectoration,chest tightness,and shortness of breath for 4 months,which were aggravated 1 weeks before admission;one for fever,accompanied with cough,shortness of breath(which was aggravated by exercise),and little sputum for 3 months,with symptoms worsened 2 days before admission;one admitted because of fever,cough,ex-pectoration,with chest tightness,shortness of breath and dyspnea(which was aggravated by exercise) for 3 months and the symptoms were worsened 1 day before admission;one due to fever with a dry cough,chest tightness and shortness of breath (which was aggravated after exercise) for one month;one admitted due to cough,fever,chest tightness and dyspnea in 2 months,as well as weight loss and symptoms aggravated 1 week before admission. After admission,all of them were misdiagnosed as having ILD,including 3 cases of nonspecific interstitial pneumonia,1 case of allergic pneu-monia and 1 case of organic pneumonia. Duration of misdiagnosis was 2 to 6 days. Subsequently,all patients were diag-nosed with AIDS complicated with PCP according to the history of patients,clinical manifestations and medical exami-nations,and received treatment accordingly. Of them,5 cases were hospitalized for 7 to 14 days;2 were discharged a-gainst medical advice;2 were transferred to specialized hospital for further treatment;1 died of respiratory failure. Four were followed up for 3 months to 1 year after discharge. During the follow-up period,2 cases suffering opportunistic in-fections and symptoms were improved after symptomatic treatment. The prognosis of 2 patients was good. Conclusion The clinical manifestations of AIDS complicated with PCP are diverse,which should be the focus of clinicians. Height-ened perception may help to reduce or avoid misdiagnosis and mistreatment of the disease.关键词
获得性免疫缺陷综合征/肺炎；肺囊虫性/误诊/肺疾病,间质性Key words
Acquired immunodeficiency syndrome/Pneumonia,pneumocystis/Misdiagnosis/Lung diseases,interstitial分类
医药卫生引用本文复制引用
张天,滕丹华..获得性免疫缺陷综合征合并肺孢子菌肺炎误诊为间质性肺疾病五例分析[J].临床误诊误治,2018,31(5):1-4,4.基金项目
湖北省卫生厅基金项目(2013L-O39) （2013L-O39）
