竹棒误穿胸致肺炎、多发性肺梗塞及脓肿1例误诊为肺结核。

Peng-Fei Qu, Bao-Liang Bai, Ting Duan, Kai Liu, Jin-Liang Du, Xin Xiong, Peng-Lin Jia, Zhong-Chun Sun, Pu-Ping Lei
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引用次数: 1

摘要

计算机断层扫描(CT)检查是检测和诊断人体异物的主要手段。虽然CT对异物的诊断具有很高的敏感性,但一些干扰因素仍可能导致漏诊或误诊。这里我们报告一个罕见的案例,一根竹竿意外刺穿了一个喝醉酒的年轻人的左胸部,他没有意识到自己受到了伤害。患者出现咳嗽、胸痛、发热、咯血等症状,经当地医院胸部CT检查误诊为原发性和继发性结核,但痰涂片未检出结核杆菌。他随后在接下来的三年中接受了抗结核治疗,但没有观察到他的症状改善。直到去世前一个月,竹竿在另一家医院通过螺旋CT检查和三维图像重建发现。尸检显示其死因为肺炎、肺梗塞和脓肿。我们分析本病例可能误诊的原因,旨在为今后肺部炎症合并异物的诊治提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pneumonia, Multiple Pulmonary Infarction and Abscess Caused by a Bamboo Stick Accidentally Piercing into Chest: a Case Misdiagnosed as Pulmonary Tuberculosis.

Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body, some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough, chest pain, fever, hemoptysis, and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital, although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years, but no improvement of his symptoms was observed. Until one month before his death, the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia, pulmonary infarction, and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case, aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.

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