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患者男性,21岁,无明显诱因咽痒、咳嗽、无发热,胸片示右下肺炎,按炎症治疗数月无好转入院。体查:T36℃,P104次/分,BP15/8kPa,发育正常,浅表淋巴结不肿大,五官无异常,右肺呼吸音稍低,心音整,律齐,腹软,肝脾未触及。实验室检查:WBC6.3×10~9/L,Hb154g/L,N80%,L15%,E5%,血小板8.4×10~(12)/L,ESR3mm/h,痰查抗酸杆菌与霉菌阴性,肺炎双球菌阳性,含铁血黄素颗粒巨噬细胞阴性,血嗜异性凝集反应1∶28阳性。血气分析:pH值7.39,PaCO_23.41kPa,PaO_28.42kPa,HCO_315.6mmoL,皮肤OT试验阴性。胸片示右肺门向外右下放射状片状模糊影,约4×5cm范围。肺功能大致正常。入院后初诊为肺炎,经抗炎及激素治疗
Male patient, 21 years old, no obvious incentive to itchy throat, cough, no fever, chest X-ray showed right lower pneumonia, according to the inflammation treatment for several months without improvement hospitalization. Physical examination: T36 ℃, P104 beats / min, BP15 / 8kPa, normal development, superficial lymph nodes are not enlarged, facial features were normal, lower right lung breath sounds, heart sound whole, regular Qi, abdominal soft, liver and spleen not touched. Laboratory tests: WBC6.3 × 10-9 / L, Hb154g / L, N80%, L15%, E5%, platelet 8.4 × 10-12 / L, ESR3mm / h, sputum check acid-fast bacilli and mold negative , Pneumococci positive, hemosiderin granule macrophage negative, blood heterophile agglutination 1:28 positive. Blood gas analysis: pH 7.39, PaCO_23.41kPa, PaO_28.42kPa, HCO_315.6mmoL, skin OT test negative. Chest radiograph showed the right hilar outward radiate flaky fuzzy film, about 4 × 5cm range. Pulmonary function is generally normal. After admission, newly diagnosed pneumonia, anti-inflammatory and hormone therapy