Trumbull M L, Chesney T M
JAMA. 1981 Feb 27;245(8):836-8.
We reviewed 30 episodes of pulmonary blastomycosis among 29 patients to compare the methods of diagnosis and to assess the usefulness of cytological sputum examination. Complement fixation and skin tests were not helpful in diagnosis. Confirmation by culture of sputum or tissue required, on average, five weeks. We compared the cytological examination of bronchial secretions with that of microbiologic wet smears. The cytological technique yielded a positive diagnosis in 93% of patients and in 70% on the first specimen. Sixty-one percent of microbiologic wet smears proved positive, with 32% positive on the first specimen. The cytological findings were reported significantly sooner. In addition, cytological diagnosis of Blastomyces dermatitidis in sputum and bronchial washings of patients suspected of having a pulmonary cancer or infection reduced the time of diagnostic workup and the incidence of major surgery.
我们回顾了29例患者的30次肺芽生菌病发作，以比较诊断方法并评估痰细胞学检查的效用。补体结合试验和皮肤试验对诊断没有帮助。通过痰液或组织培养确诊平均需要五周时间。我们将支气管分泌物的细胞学检查与微生物湿涂片检查进行了比较。细胞学技术在93%的患者中得出阳性诊断，在首次标本检查中阳性率为70%。61%的微生物湿涂片结果呈阳性，首次标本检查时阳性率为32%。细胞学检查结果报告得明显更快。此外，对疑似患有肺癌或感染的患者的痰液和支气管冲洗液进行皮炎芽生菌的细胞学诊断，减少了诊断检查时间和大手术的发生率。
