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例1,女性,34岁,医务工作者。1987年5月中旬出现于咳,疑为“上感”,服用抗生素和止咳药10天无效,咳嗽反而加重,吐粘稠痰,早晨咳出的痰呈胶质状。自觉胸部不适感。胸片见两肺纹理明显增强。全身检查除两肺呼吸音粗糙外未见其他异常。无慢性病史和长期服药史。血常规及血液检查均正常范围,痰直接涂片镜检,查到真菌菌丝。连续3次痰沙博氏基培养,有同样菌落生长。菌种鉴定:黄曲菌。临床诊断肺曲菌病。治疗经过:开始服用酮康唑200mg,Bid,3周后自觉症状明显好转,痰涂片镜检真菌菌丝较前减少,菌丝变细。因发现血清转氨酶增高停服酮康唑,改服大蒜素每次3丸,Tid。2周后咳嗽加重,吐痰增多,又服用酮康唑200mg,bd。同时二性霉素B 雾化吸入每天10mg。上述治疗3个月病情稳定,后单服酮康唑200mg,观察至今病情基本稳
Example 1, female, 34 years old, medical worker. In mid-May 1987 appeared cough, suspected “feeling”, taking antibiotics and cough 10 days is invalid, the cough aggravating, spit thick sticky sputum, phlegm was morning glial. Conscious chest discomfort. Chest radiographs clearly improved lung texture. No other abnormalities were found in the whole body except the coarse breath sounds of both lungs. No chronic medical history and long-term medication history. Blood and blood tests were normal range, sputum direct smear microscopy, found fungal mycelium. Three consecutive sputum Bordetella culture, the same colony growth. Identification of strains: Aspergillus flavus. Clinical diagnosis of pulmonary aspergillosis. After treatment: began to take ketoconazole 200mg, Bid, 3 weeks after the symptoms improved significantly, hyphae sputum smear microscopy than before reduced hyphae. Because of elevated serum aminotransferase found to stop taking ketoconazole, change service allicin 3 pills each time, Tid. Cough increased after 2 weeks, spitting increased, and taking ketoconazole 200mg, bd. At the same time, inhalation of amphotericin B 10mg daily. The treatment of 3 months in stable condition, after a single dose of ketoconazole 200mg, observed the basic stability of the disease so far