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[一名全身性粟粒性肺结核患者的急性结核性细支气管炎]

[Acute tuberculous bronchiolitis in a patient with generalized miliary tuberculosis].

作者信息

Kornetova N V, Kruze A N, Savchenko A I, Ariél' B M

出版信息

Probl Tuberk Bolezn Legk. 2003(8):47-8.

Abstract

A case study of an acute tuberculous bronchiolitis (a rarely encountered form of generalized miliary tuberculosis), whose aggravated progressing resulted in fatal outcome 2 months after the onset of the initial disease signs, is described. The prevalence of non-specific infectious-and-allergic manifestations is a clinical-and-morphological peculiarity within the case study, which confirms a diversity of morphological changes occurring in the organism in tuberculosis infection. The etiological- and pathogenetic specific features of acute tuberculous bronchiolitis in children and in adults are under discussion; in particular, a possible role of a preceding viral infection is evaluated. It is one of the cases of hematogenic generalization in primary tuberculosis of adults, observed by the authors, when an involvement of the pulmonary and parenchymatous organs as well as of arachnoids and substances of the cerebrum was registered. The presence of generalized vasculitis with fibrinoid swelling and with necrosis of collagenous fibers of medium (and with the development of pan-vasculitis in the discussed case) is typical of all such observations.

摘要

本文描述了一例急性结核性细支气管炎(一种罕见的全身性粟粒性肺结核形式)的病例研究,其病情在最初疾病症状出现后2个月内加剧进展,最终导致致命结局。非特异性感染和过敏表现的普遍性是该病例研究中的临床和形态学特征,这证实了结核病感染时机体内发生的形态学变化的多样性。本文讨论了儿童和成人急性结核性细支气管炎的病因和发病机制的具体特征;特别评估了先前病毒感染可能发挥的作用。这是作者观察到的成人原发性肺结核血行播散的病例之一,当时记录到肺部和实质器官以及蛛网膜和大脑实质均受累。所有此类观察结果的典型特征是存在伴有纤维蛋白样肿胀以及中膜胶原纤维坏死的全身性血管炎(在所讨论的病例中发展为全血管炎)。

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