Rubin S A
AJR Am J Roentgenol. 1978 Aug;131(2):277-81. doi: 10.2214/ajr.131.2.277.
Pleuropulmonary disease was seen in 50 of 62 patients (81%) with proven tularemia. Radiographic findings included patchy subsegmental air space opacities (74%), hilar lymphadenopathy (32%), and pleural effusion (30%). Less common manifestations were air space opacification of an entire lobe or segment, cavitation, oval opacities, pericardial effusion, linear opacities and septal lines, apical and miliary disease resembling tuberculosis, a mediastinal mass, empyema with bronchopleural fistula, and residual cystic changes, calcification, and fibrosis. Pleuropulmonary tularemia may be easily misdiagnosed as other infectious diseases, neoplastic diseases, and occasionally cardiac or other pericardial disease. It should be considered whenever patients from endemic areas present a perplexing radiographic and clinical picture. Such patients should have the benefit of a serologic examination for tularemia, since this disease may be effectively controlled with appropriate antibiotics.
在62例确诊为兔热病的患者中，50例（81%）出现胸膜肺部疾病。影像学表现包括斑片状亚段性气腔实变（74%）、肺门淋巴结肿大（32%）和胸腔积液（30%）。较少见的表现为整个肺叶或肺段的气腔实变、空洞形成、椭圆形实变、心包积液、线状实变和间隔线、类似肺结核的肺尖和粟粒样病变、纵隔肿块、伴有支气管胸膜瘘的脓胸以及残留的囊性改变、钙化和纤维化。胸膜肺型兔热病可能很容易被误诊为其他感染性疾病、肿瘤性疾病，偶尔也会被误诊为心脏或其他心包疾病。当来自疫区的患者出现令人困惑的影像学和临床症状时，应考虑该病。此类患者应接受兔热病血清学检查，因为这种疾病可用适当的抗生素有效控制。
