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目的探讨放线菌病的临床特点,提高临床医师对该病的认识。方法回顾性分析北京协和医院1990年1月至2006年6月确诊的9例放线菌病病例。结果 (1)9例患者中7例女性,2例男性;年龄30～50岁;病程2～36个月;(2)9例患者中面颈部病变3例,妇科病变2例,肺部及胸腔病变2例,乳腺、肠道病变各1例。其中3例患者有累及多器官的播散性病变;(3)9例中6例通过手术获得病理诊断,2例依靠痰涂片或硫磺颗粒诊断,1例由临床及理化诊断;(4)9例均使用抗生素治疗,8例好转,1例死亡。结论放线菌病临床少见,多表现为慢性脓肿,易误诊为恶性肿瘤,应引起临床医师的重视,早期诊断、及时治疗,可改善预后。
Objective To investigate the clinical features of actinomycosis and to improve clinicians’ understanding of the disease. Methods A retrospective analysis of Peking Union Medical College Hospital from January 1990 to June 2006 diagnosed 9 cases of actinomycosis cases. Results (1) Among the 9 patients, 7 were female and 2 were male. They were 30 to 50 years of age and the course of disease was 2 to 36 months. (3) Among the 9 patients, there were 3 cases of facial and neck lesions, 2 cases of gynecological lesions, And chest lesions in 2 cases, breast, intestinal lesions in 1 case. Among them, 6 cases were pathologically diagnosed by surgery, 2 cases were diagnosed by sputum smear or sulfur particles, 1 case was diagnosed by clinical and physical and chemical tests; 4) Nine patients were treated with antibiotics, 8 patients improved, 1 patient died. Conclusion Actinomycosis is rare in clinical practice, with many manifestations of chronic abscess. It is easily misdiagnosed as malignant tumor, which should be taken seriously by clinicians. Early diagnosis and timely treatment can improve the prognosis.