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粟粒性结核(简称粟结)的临床表现复杂多变,常以不寻常形式出现。我们在总结47例粟结时,有1例因误诊为风湿热贸然应用激素,导致肺结核恶化和严重自发性气胸,经多方抢救,才得脱险。现总结如下,以吸取教训,并结合文献,略加讨论。病例郭某女27岁未婚本院护士患者于1979年2月起即有午后低热乏力,曾疑肺结核,但胸部透视及X线摄片检查未发现病症,对症处理,坚持工作。 3月下旬,于一次受凉后寒战高热,体温高达39.3℃,按上感处理,体温不降,一周后于1979年4月2日住内科病房。查体未发现异常体征,各关节无红肿。化验:WBC6000,N72％,L28％,ESR60mm/1h末,粘蛋白10.5mg/dl,ASO因故未作。EKG正常。诊断风湿热,给口服强的松
The clinical manifestations of miliary tuberculosis (referred to as millet) complex and volatile, often in unusual forms. We conclude 47 cases of millet, 1 cases of rheumatoid due to misdiagnosis of the application of hormones, leading to deterioration of tuberculosis and severe spontaneous pneumothorax, after rescuing, was out of danger. Are summarized below, to learn lessons, combined with the literature, a little discussion. Case Kwok woman 27-year-old unmarried nurses in our hospital since February 1979 that afternoon, fever, fatigue, suspected pulmonary tuberculosis, chest X-ray examination and chest X-ray examination found no illness, symptomatic treatment, adhere to the work. In late March, after a cold and fever after a cold, body temperature as high as 39.3 ℃, according to the sense of treatment, body temperature does not drop, a week later on April 2, 1979 living ward. Physical examination found no abnormal signs, no joint swelling. Laboratory: WBC6000, N72%, L28%, ESR60mm / 1h end, mucin 10.5mg / dl, ASO for some reason not made. EKG is normal. Diagnosis of rheumatic fever, oral prednisone