华西医学

华西医学

如何诊治继发性肺结核合并肺奴卡菌病

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该文报道了一例患有痛风、糖尿病等多种疾病的高龄男性患者,院外诊断涂阳敏感肺结核并给予抗结核治疗,但呼吸困难症状加重、肺部影像学未改善。多学科讨论认为患者系免疫受损宿主,不排除合并细菌、真菌及特殊病原体感染,因此选择敏感抗生素治疗并合用奥司他韦和磺胺覆盖病毒及卡氏孢子菌、奴卡菌等病原体。痰菌延长培养发现皮疽奴卡菌生长,证实患者系肺结核合并肺奴卡菌病,经上述治疗患者呼吸衰竭好转。

关键词: 肺奴卡菌病; 奴卡菌; 肺结核; 免疫受损; 磺胺

引用本文: 樊涛, 张宇, 戴仲秋, 陈雪融. 如何诊治继发性肺结核合并肺奴卡菌病. 华西医学, 2018, 33(8): 1042-1045. doi: 10.7507/1002-0179.201807110 复制

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