Chan E D, Terada L S, Schwarz M I
Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, USA.
J Natl Med Assoc. 1995 Nov;87(11):826-8.
Although the leading causes of fever and pulmonary infiltrates in sickle cell patients are acute bacterial pneumonia and the acute chest syndrome, the former is usually responsive to antibiotics and not protracted, and the clinical course of the latter is short and self-limited. A patient with sickle cell anemia presented with fever and pulmonary infiltrates of several weeks duration that were unresponsive to antibiotics. Gross endobronchial abnormalities were noted on bronchoscopy, and the biopsies were consistent with sarcoidosis. The diagnosis of sarcoidosis can be difficult to establish in a patient with sickle cell anemia and protracted fever since both disorders are associated with chronic interstitial changes on the chest radiograph as well as restrictive physiology.
尽管镰状细胞病患者发热和肺部浸润的主要原因是急性细菌性肺炎和急性胸综合征，但前者通常对抗生素有反应且病程不迁延，后者的临床病程短且具有自限性。一名镰状细胞贫血患者出现持续数周的发热和肺部浸润，对抗生素无反应。支气管镜检查发现明显的支气管内异常，活检结果符合结节病。在镰状细胞贫血和长期发热的患者中，结节病的诊断可能很难确立，因为这两种疾病在胸部X光片上均与慢性间质性改变以及限制性生理学相关。
