肺结核合并肺念珠菌病12例临床分析

目的 探讨减少肺结核合并肺念珠菌病的发生和误诊?方法 以肺结核病情好转或稳定中, 出现新的症状, X 线片显示新病灶或原病灶扩大, 痰真菌培养连续三次生长同种真菌且抗真菌治疗后病情改善, 痰真菌培养无原真菌生长为标准?12 例病人被确诊合并肺念珠菌病并作回顾性分析?结果 本组病人肺结核病灶范围较广泛, 空洞多, 痰菌阳性率高, 多有高热?血白细胞和中性粒细胞数较高, 及广谱抗生素和糖皮质激素使用史, 多误诊?结论 本病易误诊, 临床应予重视, 规则使用广谱抗生素和激素可减少它的发生?

Clinical analysis of 12 cases of pulmonary tuberculosis with pulmonary candidiasis

Objective To discuss decreasing occurence and misdiagnosis of pulmonary tuberculosis with pulmonary candidiasis.Methods 12 cases were diagnosed pulmonary candidiasis.Based on:1.The patients presented fever,cough or primary symptom exaggerated.2.X ray examining showed new lesions or primary lesions enlarged.3.Same fungus grew on the culture for three times continuously.4.After antimycosis treatment,the patients condition got well,symptom dismissed,fungus didn't grow on the culture of the sputum.The above material were studied retrospectively.Results Their sphere of lesions of pulmonary tuberculosis were large,There are many cavities,high positive rate of mycobacteria(8/12).high fever,cough,expectoration,leukocytosis(15～35×10.9/L)and used antibacterial?corticoid drugs in these patients.Most of them were misdiagnosed.Conclusion Candidiasis were misdiagnosed easily and must be paid attention.It should be decreased for using regularly antibacterial?corticoid drugs.