Lim K H, Chong K L
Department of Medicine, University of Malaya, Kuala Lumpur.
Singapore Med J. 1999 Mar;40(3):176-8.
The diagnosis of disseminated tuberculosis should be entertained in all patients with unexplained fever associated with hepatomegaly and/or splenomegaly with or without anomalies in liver function tests and haemogram. It should be considered as a possible cause of septic shock especially in patients with typical risk factors such as advanced age, diabetes, alcoholism or immunosuppression. Prompt therapy could be life saving in an otherwise potentially fatal condition. It is therefore appropriate to initiate anti-tuberculosis treatment as soon as such a diagnosis is suspected and not await final confirmation.
对于所有出现无法解释的发热并伴有肝肿大和/或脾肿大,无论肝功能检查和血常规是否异常的患者,均应考虑播散性结核病的诊断。尤其对于具有典型危险因素(如高龄、糖尿病、酗酒或免疫抑制)的患者,应将其视为感染性休克的可能病因。在这种原本可能致命的疾病中,及时治疗可能挽救生命。因此,一旦怀疑有此类诊断,应立即开始抗结核治疗,而不必等待最终确诊。