肺放线菌病1例报告并文献复习  

Pulmonary actinomycosis: One Case Report and Review of the Literature

作　　者：祝冰晶[1] 熊福[1] 何建[1] 梁岚[1] 罗光明[1] 

机构地区：[1]第三军医大学西南医院呼吸内科,重庆400038

出　　处：《现代生物医学进展》2014年第14期2733-2735,共3页Progress in Modern Biomedicine

摘　　要：目的:分析肺放线菌病的临床表现、诊断及治疗,提高对肺放线菌病的认识。方法:回顾性分析我科收治的1例肺放线菌病患者的临床资料,并对相关文献进行复习。结果:本例患者,43岁,男性,以咳嗽、咳血性痰为主要临床表现,胸部CT提示右肺上叶结节,经皮肺穿刺活检结果确诊肺放线菌病,青霉素治疗效果好。结论:肺放线菌病是放线菌感染引起的一种少见的呼吸系统疾病,起病隐匿,呈渐进性过程,临床表现及影像学检查均无特异性,放线菌可在肺部引起化脓性肺炎,并经叶间隙、胸膜侵犯胸壁、肋骨,形成窦道及破坏骨质。确诊有赖于病理学或微生物学证据,主要可采用青霉素抗感染治疗,在疑似肿瘤的情况下,需通过外科手术治疗,既可以明确诊断也避免病变进一步引起肺、胸壁等组织的不可逆性破坏。Objective： To evaluate the clinical manifestation, diagnosis and treatment of pulmonary actinomycosis.and enhance the knowledge of pulmonary actinomycosis during clinical practice. Methods： The process of diagnosis for one patient with pulmonary actinomycosis was analyzed and the literatures about pulmonary actinomycosis in recent years were reviewed. Results： The 43 year old male had productive cough, bloody sputum. Thoracic computed tomography（CT） showed a 5-cm mass in the upper lobe of the right lung, CT-guided needle biopsy of the right pulmonary lesion showed pulmonary actinomycosis. The patient was good responsive to penicillin Conclusion： Pulmonary actinomycosis is a rare disease caused by Actinomyces sp with an occult beginning and progressive chronic course. Its symptoms and radiological findings are not characteristic. It may further extend into the soft tissues and bones of the chest wall causing cutaneous fistulas and osteolysis Histological examination of the pulmonary specimen established the diagnosis of pulmonary actinomycosis. Penicillin is the most commonly used empirical treatment, a shorter therapy is used more often surgery in combination with medical treatment offered reliably excellent results.

关 键 词：肺放线菌病 诊断 治疗 病例报告 

分 类 号：R563[医药卫生—呼吸系统]