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目的探讨吸收延迟肺炎误诊肺结核的原因,提高对两种疾病的鉴别诊断能力。方法对16例吸收延迟肺炎误诊肺结核病例进行回顾性分析。结果误诊患者临床表现发热10例,其中高热3例,中度发热4例,低热3例;盗汗2例;查痰结核菌均阴性;血常规检查白细胞总数在4.0～10.0×109/L之间12例;结核菌素纯蛋白衍生物(PPD)皮试阳性7例;X线胸片病变位于上叶尖后段、下叶背段16例;有肺结核病史2例。结论误诊的主要原因:吸收延迟的肺炎临床症状不典型,X线胸片、血常规检查与肺结核相似,对PPD的诊断价值估计过高。对临床资料综合分析,抗炎治疗动态观察,是防止吸收延迟的肺炎误诊肺结核的重要措施。
Objective To investigate the reasons for the misdiagnosis of pulmonary tuberculosis by delayed absorption pneumonia and to improve the differential diagnosis of the two diseases. Methods A retrospective analysis of 16 cases of misdiagnosis of pulmonary tuberculosis with delayed absorption pneumonia was performed. Results The clinical manifestations of misdiagnosed patients with fever in 10 cases, including 3 cases of high fever, moderate fever in 4 cases, fever in 3 cases; night sweats in 2 cases; sputum TB were negative; blood routine examination of the total white blood cells between 4.0 ~ 10.0 × 109 / L 12 cases; tuberculin pure protein derivative (PPD) skin test positive in 7 cases; X-ray lesions in the posterior segment of the upper lobe, lower lobe in 16 cases; history of pulmonary tuberculosis in 2 cases. Conclusions The main causes of misdiagnosis: The clinical symptoms of delayed absorption of pneumonia are not typical. X - ray and routine blood tests are similar to those of pulmonary tuberculosis, and the diagnostic value of PPD is overestimated. Comprehensive analysis of clinical data, dynamic observation of anti-inflammatory treatment is to prevent the absorption of delayed pneumonia misdiagnosis of tuberculosis important measures.