儿童原发性肺结核误诊为肺炎36例分析

目的分析儿童原发性肺结核误诊为肺炎的原因。方法对36例原发性肺结核临床表现、X线胸片、实验室检查、结核菌素试验结果进行综合分析,查找误诊原因。结果全部病例都有周身结核中毒症状,而无肺炎样高热、寒战、气急,X线胸片显示原发性肺结核记录者23例,配合胸部CT全部病例的原发性肺结核记录被确认。实验室检查,结核菌素试验亦提供了肺结核病诊断依据。结论忽视原发性肺结核与肺炎的不同临床表现,X线记录及其他特异检查,是造成误诊的主要原因。

Primary Pulmonary TB Misdiagnosed as Pneumonia in Children:A Report of 36 Cases

Objective To study the reasons of misdiagnosed primary TB as pneumonia in children.Methods The clinical manifestations,chest X-ray,laboratory examinations and PPD tests of primary tuberculosis were analyzed in 36 patients,to search into the causes of misdiagnoses.Results All patients who had the tuberculous intoxicity symptoms did not show pneumonia-like high fever,shivering,or breathlessness.The chest X-ray showed that 29 patients with primary tuberculosis had been recorded.Combined with chest CT,all the 36 patients recorded had been identified.Laboratory examination and PPD test also provided the diagnostic basis of pulmonary tuberculosis.Conclusion The main reason of misdiagnosis was the neglect of different clinical manifestations of primary tuberculosis and pneumonia on X-ray record and other examinations.