Israel R H, Poe R H, Greenblatt D W, Swalbach W G
Respiration. 1985;47(2):151-7. doi: 10.1159/000194761.
Tuberculous and nontuberculous cavitary lung disease is often initially misdiagnosed, delaying therapy. To identify findings which might help avoid such delays, we performed a retrospective review of all patients admitted to two community hospitals over a 6-year period for infectious cavitary disease of the upper lobe or apical segment of the lower lobe. 10 patients with tuberculosis and 16 with nontuberculous infections were identified. Delays in initiating therapy were common to both. Most signs and symptoms were nonspecific. The mean duration of symptoms was greater in tuberculosis (72 days) compared to nontuberculous infections (18 days). Putrid sputum was found only in nontuberculous infections (11/16). Roentgenographic features of fibronodular infiltration and atelectasis occurred only in tuberculosis. Air fluid levels were seen only in nontuberculous disease (10/16). Leukocytosis with immature neutrophils was found only in patients with nontuberculous cavities. We conclude that the previously described clinical, laboratory, and roentgenographic features may be useful in correctly diagnosing infectious cavitary lung disease.
结核性和非结核性空洞性肺病最初常被误诊，从而延误治疗。为了确定可能有助于避免此类延误的发现，我们对两家社区医院在6年期间收治的所有上叶或下叶尖段感染性空洞疾病患者进行了回顾性研究。确定了10例肺结核患者和16例非结核感染患者。两者都普遍存在治疗开始延迟的情况。大多数体征和症状都不具有特异性。与非结核感染（18天）相比，肺结核患者症状的平均持续时间更长（72天）。仅在非结核感染患者中发现恶臭痰（11/16）。纤维结节浸润和肺不张的X线特征仅出现在肺结核中。气液平面仅见于非结核疾病（10/16）。仅在非结核空洞患者中发现伴有未成熟中性粒细胞的白细胞增多。我们得出结论，先前描述的临床、实验室和X线特征可能有助于正确诊断感染性空洞性肺病。
