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结核性胸膜炎被同时发生的嗜水气单胞菌菌血症掩盖的隐匿性诊断。

Hidden diagnosis of Tuberculous pleurisy masked by concomitant Pseudomonas oryzihabitans bacteremia.

机构信息

Division of Infectious Diseases and Tropical Medicine, National Defense Medical Center, Taipei, Taiwan.

出版信息

Respir Care. 2012 Feb;57(2):298-301. doi: 10.4187/respcare.01103. Epub 2011 Jul 12.

Abstract

The clinical presentations of tuberculous pleurisy are usually nonspecific and have an insidious course, thus resulting in diagnostic challenges. Pseudomonas oryzihabitans is a nonfermenting, oxidase-negative, catalase-positive, Gram-negative bacillus that has rarely been encountered as a human pathogen. We present the case of a 30-year-old male patient who exhibited intermittent fever despite antibiotic treatment for Pseudomonas oryzihabitans bacteremia for 6 days. Tuberculous pleurisy was finally diagnosed by histopathologic and microbiologic studies. He recovered after a 2-week antibiotic course and 6-month antituberculosis treatment.

摘要

结核性胸膜炎的临床表现通常不具特异性且呈隐匿性,因此诊断颇具挑战。栖稻假单胞菌是一种不发酵、氧化酶阴性、过氧化氢酶阳性的革兰氏阴性杆菌,很少作为人类病原体被发现。我们报告了一例 30 岁男性患者的病例,该患者在接受栖稻假单胞菌菌血症的抗生素治疗 6 天后仍出现间歇性发热。结核性胸膜炎最终通过组织病理学和微生物学研究诊断。他在接受了 2 周的抗生素疗程和 6 个月的抗结核治疗后康复。

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