Misdiagnosis of pulmonary tuberculosis step down.docVIP

 PAGE \* MERGEFORMAT 5 Misdiagnosis of pulmonary tuberculosis step down [Keywords:] Misdiagnosis of pulmonary tuberculosis to step down By 1999-2006 the 21 patients were treated pulmonary tuberculosis patients to step down, more than tuberculosis in primary lung apex on the tip of the bottom or lower back, sometimes found in well-ventilated parts of the middle. The following lung field tuberculosis rare, and often the nature of lesions uniform performance of soft, relatively clear border infiltration or spherical, so easy to overlook the emergence of the clinician misdiagnosis and delayed diagnosis and treatment. 1 Clinical data 21 patients, 14 men, 7 women, aged 20 to 68 years old. Clinical symptoms are fever, cough, sputum in 21 cases, there were 6 cases of prodromal symptoms of poisoning, 10 cases of purulent sputum, hemoptysis 5 cases, night sweats in 1. Laboratory tests: WBC count increased more than 17 cases. ESR in 6 cases. check acid-fast bacilli sputum smear in 4 cases. X-ray showed 12 cases of lung field infiltration under the shadow of 5 cases spherical lesions, 4 patients had pleural thickening .17 cases of sputum smear negative for acid-fast bacilli check, PPD test was negative in 8 cases, 9 cases of positive (+~++ .21 cases, 14 cases were diagnosed within 1 month the other 7 cases misdiagnosed for up to 2 months to 11 months, the average time is 6 and a half months misdiagnosed cases misdiagnosed .21 pneumonia in 11 cases, bronchiectasis in 3 cases, 4 cases of spherical pneumonia and lung cancer in 3 cases. 2 Discussion 2.1 As the next rare lung field tuberculosis, especially lack of understanding of the characteristics of primary tuberculosis, leading to lack of knowledge, resulting in high fever with cough, purulent sputum, and hemoptysis symptoms mistaken for pneumonia, bronchiectasis, and so on. 2.2 The dependence of tuberculin test. Tuberculin test was negative for tuberculosis and the identification of non-TB cases becau