Histoplasmosis misdiagnosed a case report of kala-azar.docVIP

 PAGE \* MERGEFORMAT 5 Histoplasmosis misdiagnosed a case report of kala-azar Of: Jiang Chao Sui, Meng Li Jian, LI Jin-hui, Lin Zhen, Li Gongheng [Keywords:] leishmaniasis misdiagnosed histoplasmosis 1. Medical records introduced Patients, male, 32 years old, the driver. Recurrent fever of unknown cause 20 days, on March 2, 2006 to Baise City People’s Hospital for treatment. Admission physical examination: T 39 ~ 41 , P 90 times / min, R 20 times / min, BP 100/60 mmHg. patients of Shen Qing, chronic tolerance, poor nutrition, skin and mucous membranes without jaundice, bleeding and skin rash, no swelling of superficial lymph node body, heart normal, coarse breath sounds lungs, could be heard and a little wet rales, liver and spleen not palpable, pathological reflex was not elicited. chest CT scan: thickening of two markings, left lower lobe and posterior lobe can be seen on the patches, dot-like high density, visible front end right upper lung Festival-like high density, right middle lobe shows fuzzy video, showing inflammation of the left lung and right middle lobe, left pleural thickening. Laboratory examination: WBC 1.9 109 / L, L 10.3 109 / L, M 0.1 109 / L, RBC 4.23 1012 / L, Hb 125 g / L, PLT 14 109 / L, urine, stool routine examination, liver function tests were normal. Widal reaction (-, outside the Fiji reaction (-. bone marrow smears Check: bone marrow hyperplasia, 58.8% granulocytes, erythrocytes, 23.2%, grain: Red is 2.54:1, the proportion of cells increased, mainly by phagocytic cells, showing that engulfed a large number of Li Du’s body, and no parasites. the initial diagnosis as follows: kala-azar, chronic hepatitis B: right lung with compensatory emphysema pneumonia. the seventh day after admission, the patient deteriorated, systemic failure, after she died. 2. Pathogen form of inspection In order to clarify the diagnosis of cases, the bone marrow of patients before death were reviewed films. In the light microscope, th