粟粒性肺结核抗结核治疗中的矛盾反应。
Paradoxical reaction to antitubercular therapy in miliary tuberculosis.
作者信息
Gupta Ankush, Srivastava Vijay Kumar, Khanna Vibhu Narain, Rizvi Imran
机构信息
Department of Medical Division, Military Hospital Jodhpur, Jodhpur, Rajasthan, India.
出版信息
BMJ Case Rep. 2012 Sep 3;2012:bcr0320126142. doi: 10.1136/bcr-03-2012-6142.
Abstract
An 18-year-old boy presented with fever, weight loss and loss of appetite for 6 months duration. Investigation revealed raised erythrocyte sedimentation rate, negative sputum smear examination for acid-fast bacilli, x-ray and high-resolution CT chest showed bilateral, diffuse infiltration of lung parenchyma with miliary shadows. The patient was treated as a case of miliary tuberculosis with antitubercular therapy (ATT). On the 10th day of treatment the patient developed high-grade fever, cough and breathlessness. Chest x-ray showed an increased infiltration of lung parenchyma. The patient was diagnosed as a case of paradoxical reaction to ATT and was managed successfully with steroids.
摘要
一名18岁男孩出现发热、体重减轻和食欲不振6个月。检查发现红细胞沉降率升高，痰涂片抗酸杆菌检查阴性，胸部X线和高分辨率CT显示双肺实质弥漫性浸润伴粟粒状阴影。该患者被作为粟粒性肺结核病例接受抗结核治疗（ATT）。治疗第10天，患者出现高热、咳嗽和呼吸困难。胸部X线显示肺实质浸润增加。该患者被诊断为对ATT的矛盾反应，并通过类固醇成功治疗。
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