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1 病例报告 患者男,28岁。主因间断咳嗽、咯痰、发热两年,加重1周于2000年3月21日入院。于入院前2年无明显诱因出现咳嗽,咯黄痰伴发热、盗汗,体温最高38℃。于外院查胸片示右肺中上叶大面积高密度阴影。按肺炎治疗10余天,复查胸片较前无变化。后查OT试验、支气管镜检查均无异常发现,刷检未获瘤细胞。1年前再次出现高热,盗汗及纳差。复查支气管镜,灌洗液培养为毛霉菌,绿脓杆菌。经氟康唑、磷霉素等治疗后,体温降至38℃以下,仍有咳嗽,咯黄痰,间断痰中带血,偶有铁锈色血块。入院前反复多次胸片及CT检查,右肺上叶阴影均无明显变化,1周前再次出现高热而入院。查体:体温38.5℃,脉搏105次/分,呼吸20次/分,血压:110/70 mmHg(1 mmHg=0.133 kPa)。神清合作,轻度贫血貌,右锁骨上可及1个2cm×3cm大小淋巴结,质
1 case report patient male, 28 years old. Mainly due to intermittent cough, expectoration, fever for two years, an increase of 1 week in March 21, 2000 admission. 2 years before admission no obvious incentive to cough, slightly phlegm with fever, night sweats, body temperature up to 38 ℃. Examination of the chest outside the hospital showed a large area on the right lung, high-density shadow. Treatment of pneumonia by more than 10 days, review the chest no change compared with the previous. After checking OT test, bronchoscopy showed no abnormalities, brush test without tumor cells. A year ago again high fever, night sweats and anorexia. Review bronchoscopy, perfusate culture to Mucor, Pseudomonas aeruginosa. After fluconazole, fosfomycin and other treatment, the body temperature dropped below 38 ℃, there are still cough, slightly yellow sputum, intermittent sputum bloody, occasional rust colored blood clots. Repeated chest radiography before admission and CT examination, no significant changes in the shadow of the upper lobe of the lungs, fever appeared again a week ago and admission. Examination: body temperature 38.5 ℃, pulse 105 beats / min, breathing 20 beats / min, blood pressure: 110/70 mmHg (1 mmHg = 0.133 kPa). Clear cooperation, mild anemia, the right clavicle and a 2cm × 3cm size of lymph nodes, quality