Stevan S, Vetter W, Lukaschek J
Medizinische Poliklinik, Departement für Innere Medizin, Universitätsklinik Zürich.
Praxis (Bern 1994). 1999 Nov 11;88(46):1918-22.
A 53 year old Italian with aethylic cirrhosis of the liver was hospitalized repeatedly over the last years because of recurrent ascites. During the last episode with fever, acute abdominal pain, exsudative ascites and elevated CRP spontaneous bacterial peritonitis was suspected and the patient was treated with antibiotics. Although the therapy was carried out correctly it had no effects on the symptoms. Finally the examination of ascites and matutinal sputum revealed mycobacterium tuberculosis and pulmonary and peritoneal tuberculosis was diagnosed. Tuberculostatic therapy was initiated with ethambutol, rifampicin and isoniacid adapted to impaired hepatic and renal function.
一名53岁的意大利男性,患有酒精性肝硬化,在过去几年中因反复出现腹水而多次住院。在最后一次发作时,患者伴有发热、急性腹痛、渗出性腹水和CRP升高,怀疑为自发性细菌性腹膜炎,遂接受抗生素治疗。尽管治疗方法正确,但症状并无改善。最终,腹水和晨痰检查发现结核分枝杆菌,确诊为肺结核和结核性腹膜炎。开始使用乙胺丁醇、利福平和异烟肼进行抗结核治疗,并根据肝肾功能损害情况进行调整。