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患者,男性,50岁。因咳嗽、咯带腐臭味的白色粘液痰,伴低热6个月,诊断为肺部感染。入院前4个月曾患“右下肺炎”,经庆大霉素及氨基(艹卡)青霉素治疗两周后痊愈。有风湿性脊柱炎7年。长期口服中药单方3年。体检:颈椎强直。心肺听诊无异常。常规检验及肝、肾功能均正常。X线胸片两下肺纹紊乱。痰涂片找霉菌8次(-)、普通培养两次为大肠杆菌,墨汁染色涂片两次找到新型隐球菌。纤维支气管镜(简称纤支镜)检查,于声门下2cm开始,气管、隆突,右主支气管直至上中叶管口、左主支气管直至上叶管口,粘膜广泛充血、肿胀,弥漫覆盖灰白色斑点状或斑块状组织,管腔轻度狭窄;病检(病理号862694)为鳞状上皮过度角化。活检组织霉菌培养及刷检墨汁染色涂片均可见到新型隐球菌。刷检细菌培养为枸橼酸盐杆菌。患者服用的中药单方,经本院药检室检验地塞米松呈阳性反应,该中药内含有地塞米松。诊断为气管、支气管隐球菌病合并细菌感染。
Patient, male, 50 years old. Due to cough, slightly stinky white mucus sputum, with fever for 6 months, diagnosed as lung infection. Four months prior to admission, he had “lower right pneumonia” and was cured after two weeks of treatment with gentamycin and amino (carbaryl) penicillin. Rheumatoid spondylitis 7 years. Long-term oral Chinese medicine unilateral 3 years. Physical examination: cervical spine. Cardiopulmonary auscultation no abnormalities. Routine tests and liver and kidney function are normal. X-ray two lung pattern disorder. Sputum smear fungus 8 times (-), common culture twice for Escherichia coli, ink stain smear twice found Cryptococcus neoformans. Fiber bronchoscopy (bronchoscopy) examination, at the beginning of 2cm under the glottis, trachea, carina, right main bronchus until the middle of the leaflets, left main bronchus until the upper leaf orifice, the mucosa is extensive congestion, swelling, covered with gray spots Like or plaque tissue, lumen stenosis; disease examination (pathology 862694) squamous epithelial hyperkeratosis. Biofilm mold culture and brushing ink stain smear can be seen in Cryptococcus neoformans. Brushing bacteria culture for Citrobacter. Patients taking traditional Chinese medicine unilateral, dexamethasone positive test by the hospital drug examination room, the medicine contains dexamethasone. Diagnosis of trachea, bronchial cryptococcosis with bacterial infection.