42例布鲁菌病临床误诊个例的综合分析

目的探讨布鲁菌病常见的误诊及其误诊的主要原因。 方法搜索布鲁菌病误诊个例文献。收集共42篇42例布鲁菌病的误诊文献，进行一般情况、误诊疾病、感染途径、确诊方式、地区分布以及预后及不良事件等进行统计分析。 结果42例布鲁菌病患者，男女之比3.2︰1，平均年龄42.3岁，误诊时间最短1周，最长7年。误诊疾病涉及8个系统或组织的29种疾病。感染途径：有明确接触史38例（90.5%）、无任何接触史2例（4.8%）、未描述接触史2例（4.8%）。确诊方式：血清学确诊34例（80.9%）、生物学培养确诊8例（19.1%）。地区分布：42例分布于15个省市自治区，涉及专业科室11个。临床转归：总有效率97.6%。误诊期间出现不良事件4例（9.5%）。 结论布鲁菌病危害之广、误诊疾病之多为其他疾病所罕见。病史采集欠详细、对布鲁菌病认识不足和过度依赖设备检测是该病误诊的主要原因。

Comprehensive analysis on clinical misdiagnosis of 42 cases with brucellosis

ObjectiveTo investigate the misdiagnosis disease of Brucellosis disease and the main causes of misdiagnosis. MethodsThe misdiagnosed cases literature on the internet were selected. The general situation, misdiagnosed disease, infection route, diagnosis method, region distribution, prognosis and adverse events were analyzed, among the 42 cases of brucella misdiagnosis respectively. ResultsThe ratio of male and female was 3.2︰1 and the average age of the 42 patients was 42.3 years old. The shortest misdiagnosis time was 1 week and the longest was 7 years. The misdiagnosed diseases involved 29 kinds in 8 systems or organizations. There were 38 cases (90.5%) with clear contact, 2 cases (4.8%) without contact and 2 cases (4.8%) not mentioned in statistical results of infection route. The diagnosis ways were 34 cases (80.9%) in serological diagnosis and 8 cases (19.1%) in biological cultivation. The 42 cases distributed in 15 provinces and autonomous regions and involved 11 departments. The total efficiency of clinical outcome was 97.6%. Four cases (9.5%) with adverse events occurred during misdiagnosis. ConclusionsBrucellosis has an extensive harm and many misdiagnosed diseases, compared with other diseases. The main causes of misdiagnosis were no detailed history-taking, lack of awareness of bacillus disease and excessive reliance on equipment test results.