耶氏肺孢子菌肺炎误诊为肺结核1例  

Pneumocystis jiroveci pneumonia misdiagnosed as pulmonary tuberculosis:a case report

作　　者：黄一歌 王琳琳[2] 周锦桃[2] HUANG Yige;WANG Linlin;ZHOU Jintao(Suzhou Medical College of Soochow University,Suzhou,Jiangsu 215000,China;Department of Respiratory and Critical Care Medicine,Taicang Hospital Affiliated to Soochow University,Taicang,Jiangsu 215400,China)

机构地区：[1]苏州大学苏州医学院,江苏苏州215000 [2]苏州大学附属太仓医院呼吸与危重症医学科,江苏太仓215400

出　　处：《安徽医药》2025年第4期780-782,共3页Anhui Medical and Pharmaceutical Journal

基　　金：苏州太仓市医疗卫生应用基础研究项目(TC2019JCYL03);苏州市2023年度第二十三批科技发展计划项目(SLT2023014)。

摘　　要：目的总结分析1例耶氏肺孢子菌肺炎误诊为肺结核病人的诊疗经过,为临床医生积累经验。方法收集2023年8月苏州大学附属太仓医院呼吸与危重症医学科收治的1例耶氏肺孢子菌肺炎误诊为肺结核病人的临床资料,探讨其疾病特点,总结误诊原因。结果病人主诉“咳嗽伴间断发热2个月”,当地医院起初以呼吸道感染予以常规抗感染治疗,效果不佳,行胸部CT检查提示肺部空洞样改变,考虑肺结核可能,予以诊断性抗痨治疗;转入该院后行支气管肺泡灌洗液宏基因组二代测序(mNGS)确诊为耶氏肺孢子菌肺炎,调整治疗方案后病情痊愈。结论耶氏肺孢子菌肺炎临床少见,临床缺乏特异性,应尽早与其他疾病鉴别,避免误诊误治。Objective To summarize and analyze the diagnosis and treatment of one case of pneumocystis jiroveci pneumonia misdiagnosed as pulmonary tuberculosis,so as to accumulate experience of clinical practice.Methods The clinical data of one case of pneumocystis jiroveci pneumonia misdiagnosed as pulmonary tuberculosis in the Department of Respiratory and Critical Care Medicine of Taicang Hospital Affiliated to Suzhou University in August 2023 were collected,the disease characteristics were discussed,and the causes of misdiagnosis were summarized.Results The patient complained of"cough accompanied by intermittent fever for 2 months".Initially,routine antiinfection treatment was given to respiratory infections in the local hospital,but the effect was not satisfactory.Chest CT examination showed pulmonary cavitary changes,suggesting the possibility of pulmonary tuberculosis,and diagnostic antituberculosis treatment was given;After transferring to Taicang Hospital Affiliated to Soochow University,the patient was diagnosed with pneumocystis jiroveci pneumonia through bronchoalveolar lavage fluid mNGS.After adjusting the treatment plan,the condition recovered.Conclusions Pneumocystis jiroveci pneumonia is rare and lack of specificity in clinic practice.It is necessary to differentiate it from other related diseases as early as possible so as to avoid misdiagnosis and mistreatment.

关 键 词：肺孢子菌肺炎 高通量核苷酸序列分析 二代测序 肺结核 误诊 误治 

分 类 号：R519[医药卫生—内科学]