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患者女,48岁,护士,于1984年4月10日受凉后出现畏寒、高热,达39℃,伴咳嗽、痰血、乏力、盗汗、体重减轻,时有右侧胸痛。一个半月后症状加重,并出现面部浮肿,胸闷,气急,不能平卧。胸片示右上肺片状模糊阴影及右肺门影增大。用青霉素和庆大霉素静滴28d热退,痰血消失,肺部异常阴影明显缩小,但气急无改善。起病后3个月发现右侧胸腔积液。经痰和胸水检验、纤维支气管镜检查未能确诊。试验性抗结核治疗无效。于7月23日转入我院。既往有阵发性心动过速史。否认结核病史。
The female patient, 48 years old, was a nurse who developed chills and fever after a cold on April 10, 1984, at 39°C with coughing, blood stasis, fatigue, night sweats, and weight loss. There was right chest pain. One and a half months later, the symptoms worsened, and my face was swollen, chest tight and short of breath. I could not lie flat. The chest radiograph shows that the right upper lung patchy shadows and the right lung portal image increase. With penicillin and gentamycin infusion for 28 days, the blood flow disappeared, and the abnormal shadow in the lungs was significantly reduced, but there was no improvement in shortness of breath. The right pleural effusion was found 3 months after onset. Transsphenoidal and pleural fluid tests and fiberoptic bronchoscopy failed to confirm the diagnosis. Experimental anti-tuberculosis treatment is ineffective. It was transferred to our hospital on July 23. There has been a history of paroxysmal tachycardia. Denies TB history.