Misdiagnosed as pulmonary fungal infection in 1 case of lung cancer.doc

 PAGE \* MERGEFORMAT 4 Misdiagnosed as pulmonary fungal infection in 1 case of lung cancer [Keywords:] pulmonary fungal infection, patch video, fiberoptic bronchoscopy, brush smear In recent years, the broad-spectrum antibiotics, corticosteroids, cytotoxic drugs and the widespread use of immunosuppressive agents, pulmonary fungal infections a growing trend, X-ray manifestations of bronchial pneumonia, lobar pneumonia, diffuse small nodules, and even mass of the shadows and empty, from imaging and clinical performance can easily be misdiagnosed as lung cancer or tuberculosis, fiberoptic bronchoscopy brush smear it on the early diagnosis plays a crucial role. 1 Clinical data 1.1 The case selection of patients, male, 72 years old. Diagnosis lt;lt;pulmonary fungal infection in the diagnostic criteriagt;gt;, history of physical health, no abscess, tuberculosis, lung cancer, nodules history. 1.2 Clinical manifestations of respiratory infections in patients with significant medical history, course of treatment when there are more than 40 days, fever and cough, body temperature of 37.2 ~ 38 , slightly small amount of white sputum, no hemoptysis, no fatigue, night sweats and chest pain. 1.3 The auxiliary examination RBC 4.45 109 / L, Hb 142g / L, WBC 9.0 109 / L, neutral 0.819, ESR 78mm / h, normal routine urine and faeces, blood lipids, blood glucose, liver and kidney function was normal, 24h sputum concentration Charles M. tuberculosis (-, chest X-ray showed: right upper lobe patchy inflammation. CT shows: the limitations of right upper apical posterior segment piece floc density increased shadow, edge blur, local pleural thickening. 1.4 Treatment and prognosis based on the above characteristics, consider the following possibilities: (1 lung inflammation: the history of patients with moderate degree of fever, chest radiograph with shadow, without a lot of purulent history slightly, according to treatment for pneumonia with ceftriaxone 2g / d, to