布鲁菌病临床误诊个例复习及预防

目的探讨布鲁菌病误诊、误治的常见疾病，以增加临床对布鲁菌病的认知度。 方法通过对布鲁菌病误诊个例的文献复习，将误诊疾病按系统进行分类分析。 结果布鲁菌病累及呼吸系统可被误诊为重感冒、支气管炎、支气管肺炎、支原体肺炎、结核性胸膜炎或胸膜间皮瘤，累及循环系统可被误诊为病毒性心肌炎或风湿性心脏病，累及消化系统可被误诊为药物性肝炎、肝硬化或胆道蛔虫病，累及血液系统可被误诊为恶性淋巴瘤，累及神经系统可被误诊为脊髓炎，累及运动系统可被误诊为痛风性关节炎、髋关节滑膜炎、腰椎骨折、腰椎间盘突出或腰椎结核，累及生殖系统可被误诊为睾丸炎、附件炎或先兆早产，其他也可被误诊为成人Still病。 结论布鲁菌病可被误诊为多系统、多器官疾病。详细追问患者的流行病学史、常规进行试管凝集试验（SAT）和虎红平板凝集试验（RBPT）检测是减少布鲁菌病误诊误治的有效途径。

Literature review and prevention countermeasures for Brucellosis misdiagnosis

ObjectiveTo investigate the common misdiagnosis diseases of Brucellosis and to improve the clinical recognition of Brucellosis. MethodsThe literatures of Brucellosis misdiagnosis were reviewed, while the misdiagnosed diseases according to the system were classified. ResultsThe relative respiratory system diseases caused by Brucellosis were misdiagnosed as heavy cold, bronchitis, bronchopneumonia, mycoplasma pneumonia, tuberculosis, pleurisy or pleural mesothelioma. The relative circulation system diseases caused by Brucellosis were misdiagnosed as viral myocarditis or rheumatic heart disease. The relative digestive system diseases caused by Brucellosis were misdiagnosed as drug-induced hepatitis, liver cirrhosis or biliary ascariasis. The relative blood system diseases caused by Brucellosis were misdiagnosed as malignant lymphoma. The relative nerve system diseases caused by Brucellosis were misdiagnosed as myelitis. The relative motor system diseases caused by Brucellosis were misdiagnosed as gouty arthritis, hip synovitis, lumbar spine fracture, lumbar disc or lumbar spinal tuberculosis. The relative reproductive system diseases were caused by Brucellosis misdiagnosed as precursor orchitis, adnexitis or premature birth. Others could be misdiagnosed as adult Still disease. ConclusionThe Brucellosis was misdiagnosed as multi-system and multi-organ diseases. Detailed tracking epidemic history and routinely rose bengal plate agglutination test (RBPT) and standard agglutination test (SAT) detection is an effective way to increase the Brucellosis misdiagnosis.