1 case of bone marrow and the diagnosis and treatment of tuberculosis.docVIP

 PAGE \* MERGEFORMAT 9 1 case of bone marrow and the diagnosis and treatment of tuberculosis [Keywords:] tuberculosis; bone marrow; diagnosis; pathology; Experience TB is the systemic blood of bone marrow disseminated tuberculosis in bone marrow lesions, clinically very rare. Because the lack of specific clinical manifestations, diagnosis very difficult, misdiagnosis is high, tuberculosis of bone marrow to increase awareness, understanding its characteristics, prognosis and treatment, are reported in our hospital TB cases and 1 case of bone marrow, combined with analysis of the literature. 1 Clinical data 1.1 General Information Female patient, 52 years old, recurrent fever 5 more than a month. Were no obvious incentive to fever, body temperature 38.5 ~ 40 , after no improvement in the regular anti-infection treatment, and the emergence of fever with night sweat, anorexia, weight loss, no chills, joint pain , skin rashes, hair loss, mouth ulcers .3 months ago in the hospital treatment outside the hospital, diagnosis is still not clear, to the naproxen control body temperature and discharged. patients with persistent fever 37.5 ~ 38 , weight loss, weight loss 10 kg. 1.2 Laboratory tests WBC 19.8 109 / L, N 87.3%, HGB 116 g / L, PLT 182 109 / L, ESR 118 mm / h, GLB 39.4 g / L, ALP 307 U / L (47 138 U / L), GGT 126 U / L (6 ~ 46 U / L), CK 27 U / L (20 ~ 140 U / L), LDH 468 U / L (110 ~ 220 U / L), HBDH 361 U / L (72 ~ 182 U / L), AST 43 U / L (lt;37 U / L), ALT 28 U / L (lt;38 U / L), a full set of negative blood transfusion, RF 35.9 U / mL (lt;20) CRP 88.6 mg / L, anti-”O” negative, IgG 15.6 G / L, normal complement, ANA and ENA were negative spectrum, ANCA negative, negative anti-CCP, AKA negative, anti-RiB negative, HLA B27 negative Widal negative reaction outside the Philippines, check sputum negative for acid-fast bacilli 3, ferritin 1 677.8 ng/ml.CD4 48.1%, CD8 13.7%, normal thyroid function, tumor mark things CA15 3 40.26 U / ml, 3 t