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支气管结核并复发性自发性气胸:一例报告。

Bronchial tuberculosis with recurrent spontaneous pneumothorax: A case report.

机构信息

The Affiliated Hospital of Qinghai University, Xining, 810001, China.

Department of Respiratory Medicine, The Affiliated Hospital of Qinghai University, Xining, 810001, China.

出版信息

BMC Pulm Med. 2023 Mar 21;23(1):93. doi: 10.1186/s12890-023-02374-y.

Abstract

BACKGROUND

Spontaneous pneumothorax associated with tuberculosis due to clinical manifestations, imaging findings and negative pleural biopsy is rare.

CASE REPORT

A 43-year-old young woman went to the hospital several times because of recurrent dyspnea and was diagnosed with a right spontaneous pneumothorax. She underwent multiple closed thoracic drainage procedures, but the pneumothorax was not completely resolved. Pleural biopsy pathology was chronic inflammation; there was no evidence of tuberculosis. A small amount of pneumothorax persisted, intermittent dyspnea became more severe, and pneumothorax increased. Bronchoscopy showed thickening of the left lung lingular segment mucosa, and the bronchial lavage fluid gene X-PERT/rifampicin resistance test was positive. After one month of anti-tuberculosis treatment, the symptoms of short breath were completely relieved, and chest computerized tomography (CT) showed complete resolution of the right pneumothorax.

CONCLUSIONS

When searching for the cause of spontaneous pneumothorax, people should not overlook tuberculosis-related secondary pneumothorax, which should be diagnosed and treated as soon as possible.

摘要

背景

临床表现、影像学表现和胸膜活检阴性的结核相关自发性气胸较为罕见。

病例报告

一名 43 岁年轻女性因反复发作性呼吸困难多次就诊,被诊断为右侧自发性气胸。她接受了多次胸腔闭式引流术,但气胸并未完全缓解。胸膜活检病理为慢性炎症;无结核病证据。少量气胸持续存在,间歇性呼吸困难加重,气胸增加。支气管镜检查显示左肺舌段黏膜增厚,支气管灌洗液基因 X-PERT/利福平耐药检测阳性。抗结核治疗 1 个月后,呼吸困难症状完全缓解,胸部计算机断层扫描(CT)显示右侧气胸完全吸收。

结论

在寻找自发性气胸的病因时,不应忽视与结核相关的继发自发性气胸,应尽快诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ff/10029200/72782ef68ebc/12890_2023_2374_Fig1_HTML.jpg

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