肺曲霉病误诊原因分析

目的 探讨并分析导致肺曲霉病患者误诊的原因,为早期诊断并及时正确治疗提供科学的依据.方法 回顾性分析2010年1-4月问确诊为肺曲霉病的3例患者在诊治过程中被误诊的原冈.结果 3例患者均缺乏明显的特异性临床表现和影像学表现.最后确诊均依据病理学活检证实.结论 肺部的曲霉菌感染缺乏特异性的f临床和影像学表现,及早行纤维支...     

肺结核误诊为支气管肺炎1例

1病历摘要 女，6月龄。因反复咳喘住院3次，前2次均诊断为支气管肺炎，住院7d，11d好转出院。本次因咳喘伴发热6d入院。查体：T37．7℃，P124次／min，R36次／min，神志清，营养不良外貌，周身浅表淋巴结无肿大，双肺可闻及干鸣音及中小水泡音.     

变应性支气管肺曲菌病误诊肺结核10例分析

目的 加强对变应性支气管肺曲菌病（ABPA）的认识,减少误诊的发生.方法 回顾性分析ABPA误诊肺结核10例的临床资料.结果 本组10例主要临床表现为咳嗽、咳痰、发热,伴有乏力、食欲缺乏、盗汗等全身中毒症状.结合患者胸部影像学表现及痰培养结果,初诊误诊为肺结核.予抗结核治疗后,病情好转但长期反复发作,至上级医院经高分辨率CT、免疫功能检测等检查确诊为ABPA.予糖皮质激素、伊曲康唑治疗,症状好转,各项实验室指标趋于正常.结论 对于有哮喘病史、经正规抗结核治疗后病情好转与恶化反复交替、痰培养始终未找到结核菌者,应想到ABPA的可能,尽早完善相关医技检查,以减少误诊的发生.     

肺移植术后的气管支气管曲霉病

目前肺移植是终末期肺疾病的唯一选择。侵袭性曲霉病仍然是肺移植术后的重要并发症,早期诊断困难,抗真菌药物的毒性及与免疫抑制药物的相互作用,导致其病死率较高。最近越来越多的文献     

肺曲霉病误诊肺结核4例分析

目的 探讨肺曲霉病与肺结核两者间的鉴别诊断在临床工作中的重要性.方法 对4例肺曲霉病误诊行为肺结核进行临床分析.结果 4例患者均确诊为肺曲霉病.结论 肺曲霉病与肺结核在临床症状、胸部X线、CT表现上相似,互相干扰,对诊断造成影响,易造成误诊.所以,对临床病史、体征、影像、病理检查进行综合分析非常重要.     

支气管肺囊肿长期误诊为肺结核26例分析

支气管肺囊肿误诊率较高 ,且大多误诊为肺结核[1] 。长期误诊及错误的抗结核治疗给患者造成巨大痛苦。通过对我院近年来手术及病理证实的 2 6例误诊病例分析 ,就其误诊原因及鉴别诊断进行讨论。1　临床资料1.1　病例选择　男性 18例 ,女性 8例 ;年龄 14～ 5 1岁 ,平均 3 2岁。症状 :反复呼吸道感染 2 4例 ,起始咳黄粘胶样痰者 4例 ,咯血 13例 (其中反复大咯血 1例 ) ,间断喘息 4例 ,无症状体检发现 2例。体征 :肺部干湿音 16例 ,管状呼吸音 4例 ,一侧胸部塌陷 11例 ,呼吸音减低 16例 ,杵状指 8例 ,无明显体征 6例。1.2　Ｘ线表现　①圆形…     

误诊为肺癌的支气管内膜结核

成人支气管内膜结核大多继发于空洞型或浸润型肺结核,结核菌随分泌物播散并直接侵犯支气管粘膜。由于缺乏对本病的认识,加之该病临床表现无特异性,X 线胸部表现和纤维支气管镜(纤支镜)肉眼观与肺癌常相似,导致临床误诊,本文报道5例。一、临床资料本组5例,①临床症状、②胸部 X 线检查、③纤支镜检查等情况如下:例1:女,48岁。①咳嗽、胸闷、低热、乏力3     

支气管异物误诊为肺结核1例分析

对支气管异物误诊为肺结核1例分析如下。 1摘历摘要女，47岁。因反复咳嗽咳痰2a、痰中带血4个月入院。2a前无诱因起咳嗽、咳痰未行诊治，可自行缓解，受凉后复发，以干咳为主，咳少许白色粘痰，4个月前受凉后咳嗽、咳黄痰，伴痰中带血丝。在外院间断行抗感染治疗2月后无痰中带血，仍咳嗽、     

急性支气管肺炎误诊为肺结核1例分析

对急性支气管肺炎误诊为肺结核1例分析如下。     

变态反应性支气管肺曲霉病一例及文献复习

目的报道并分析1例变态反应性支气管肺曲霉病(ABPA)的诊断和治疗。方法采用病例报告的方式对2010年10月至2011年9月1例ABPA病例进行分析。结果患者诊断ABPA明确,治疗效果明显。结论 ABPA临床早期诊断困难,需要尽早进行痰培养、血清总IgE等相关检查以明确诊断,激素和抗真菌药物是目前有效的治疗方法,早期诊断、早期治疗能改善患者预后。     

Allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis is primarily an immunologic disorder manifested by episodic bronchial obstruction (asthma or chronic obstructive pulmonary disease). The host response to local Aspergillus antigens gradually results in irreversible pulmonary injury. A high index of suspicion is required to make the diagnosis. Early and aggressive treatment is important in preventing the serious consequences of central bronchiectasis, pulmonary fibrosis and cor pulmonale.     

Allergic bronchopulmonary aspergillosis

The article concerns one of the present-day problems in the teaching of the allergic diseases of the lungs, namely allergic bronchopulmonary aspergillosis. Discusses the disease diagnosis and clinical course, diagnostic approaches, efficient drug therapy, and prognostic aspects. Based on an analysis of the authors' own data, the problem of the possibility of the systemic pathoimmune manifestations associated with skin, eye and kidney injuries that occur during allergic bronchopulmonary aspergillosis is discussed.     

Allergic bronchopulmonary aspergillosis: an increasing clinical problem.

Allergic bronchopulmonary aspergillosis is being recognized with increasing frequency in the United States. The characteristics of the disease are recurrent pyrexia, cough, wheezing, sputum plugs containing aspergilli, fleeting pulmonary infiltrates, eosinophilia, dual skin reactions (immediate and late), and antibodies to the fungus in the blood. The pathogenetic mechanism is believed to involve type I and type III hypersensitivity reactions. Adrenal corticosteroids are effective in treating this condition.     

Allergic bronchopulmonary aspergillosis. An increasingly common disorder among asthmatic patients

Allergic bronchopulmonary aspergillosis (ABPA), an immunologic disorder, is characterized by bronchial colonization with Aspergillus species, resulting in chronic antigenic stimulation. Hallmarks of the disorder are asthma, cutaneous and serologic evidence of hypersensitivity to Aspergillus organisms, and fleeting pulmonary infiltrates. Diagnosis requires a high index of suspicion. Early diagnosis, aggressive therapy, and serial monitoring of serum IgE levels usually prevent progression of ABPA to bronchiectasis, pulmonary fibrosis, respiratory failure, and death.     

Allergic bronchopulmonary aspergillosis and sensitization to Aspergillus fumigatus in chronic bronchiectasis in adults

Fifty adult subjects for whom a diagnosis of idiopathic bronchiectasis (excluding those secondary to tuberculosis or hypogammaglobulinaemia) had been confirmed previously were investigated by: questionnaire; blood eosinophil count; sputum culture for Aspergillus fumigatus and eosinophil count; chest radiography; skin-prick tests with several aeroallergens and four preparations of A. fumigatus, including a reference extract; measurement of specific IgE antibodies; precipitin testing and self-crossed immunoelectrophoresis with A. fumigatus. Five subjects were possible cases of allergic bronchopulmonary aspergillosis in whom the condition had been previously misdiagnosed or in whom sensitization to A. fumigatus had occurred after the onset of bronchiectasis. These five subjects had positive immediate skin reactions to A. fumigatus and a history of recurrent pneumonias. Four had a previous history of asthma and the others showed increased bronchial responsiveness to inhaled methacholine. At the time of the survey, A. fumigatus grew in the sputum of one out of five subjects. These subjects had increased levels of specific IgE. Two had precipitins by double diffusion and three subjects were positive on self-crossed immunoelectrophoresis. It is concluded that allergic bronchopulmonary aspergillosis or evidence of sensitization to A. fumigatus can be identified in a significant proportion of adult subjects with so-called idiopathic bronchiectasis.     

Diagnosis of allergic bronchopulmonary aspergillosis

Five patients (4 men and 1 woman) afflicted with bronchopulmonary aspergillosis (ABPA) were examined. The main criteria for the diagnosis were a high level of the total IgE, demonstration of specific IgE to Aspergillus fumigatus, positive skin tests with antigens of moldy fungi. All the 4 patients with active process, not given corticosteroids, manifested eosinophilia of the sputum and peripheral blood. The clinical picture of bronchial asthma was recorded in 2 patients. It is desirable that all the patients with protracted and relapsing infiltrative processes in the lungs running with sputum and blood eosinophilia undergo examinations for the presence of ABPA.