Schmid G P, Catino D, Suffin S C, Martone W J, Kaufmann A F
Am Rev Respir Dis. 1983 Aug;128(2):314-6. doi: 10.1164/arrd.1983.128.2.314.
Granulomatous pleuritis, diagnosed by pleural biopsy, is rarely caused by disease processes other than tuberculosis. We present a case of granulomatous pleuritis caused by Francisella tularensis that occurred in a 55-yr-old male sheep shearer with an exudative, lymphocytic, pleural effusion. Confirmation of the diagnosis was made by elevated serum agglutination titers against F. tularensis and detection of the organism in a pleural biopsy specimen by the glucose oxidase immunoenzyme technique. We conclude that F. tularensis, not previously described as a cause of granulomatous pleuritis, must be considered in the differential diagnosis of granulomas found in pleural biopsy specimens.
经胸膜活检确诊的肉芽肿性胸膜炎，很少由结核病以外的疾病过程引起。我们报告一例由土拉弗朗西斯菌引起的肉芽肿性胸膜炎病例，该病例发生在一名55岁的男性剪羊毛工人身上，伴有渗出性、淋巴细胞性胸腔积液。通过检测血清中土拉弗朗西斯菌凝集效价升高以及采用葡萄糖氧化酶免疫酶技术在胸膜活检标本中检测到该病原体，确诊了该病例。我们得出结论，在胸膜活检标本中发现肉芽肿的鉴别诊断中，必须考虑土拉弗朗西斯菌，此前它未被描述为肉芽肿性胸膜炎的病因。
