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儿童及青年为易感人群儿童症状轻微,成人较严重发热、咽痛、咳嗽,痰可呈脓性,常有呼吸困难可并发心肌炎、心内膜炎、脑膜炎胸部X线:小片浸润影、实变影衣原体抗体效价升高衣原体肺炎01多发生在免疫低下患者和长时间接受广谱抗生素治疗的患者念珠菌肺炎:持续发热,痰粘稠不易咳出或呈胶冻状,胸片常见片状浸润和融合,常有空洞02侵袭性肺曲霉菌病:发热、咳嗽、胸痛,咯血常见。胸CT可见浸润影边缘有晕轮征,可有空洞0304肺隐球菌病:发热、干咳、气急。胸片表现多样,常见单发或多发结节,常有空洞形成肺毛霉菌病:高热、咳嗽、胸痛、呼吸困难。胸片示迅速融合的肺实变,常有空洞形成05真菌性肺炎的临床特点白色念珠菌肺炎*Diffusebilateralair-spaceopacitiesconsistentwithpneumonia.PossiblecausativeorganismsincludePneumocystiscarinii.男性,43岁,4-6周来气短gaywhitemanwhopresentstoyourofficeforthefirsttimewithacomplaintofworseningshortnessofbreathoverthepast4to6weeks.GaryclaimshereceivedapositiveresultfromanHIVtest7yearsagoandhasseenadoctoronceortwicesincethen.Headmitsthathepreferredtoignorehisdiagnosisandsuspectsthatitmayhavebeenwrongbecausehehasfeltwell.Thedoctorshesawintheinterimpronouncedhimhealthy,butheacknowledgesthathewithheldbothhissexualityandtheearlierHIVtestresultsfromthemafebrile,withaheartrateof90beatsperminute;respiratoryrate,18breathsperminute;andbloodpressure,120/80mmHg.Hisoxygensaturationonroomairis92%Hislactatedehydrogenase(LDH)levelis599U/L,andhiswhitebloodcellcountis6.23103/μL.Hishemoglobinlevelis12.1g/dLandhematocritis35.4%.CD4cellcountis25/μL非典型病原体指衣原体、支原体、军团菌**Chlamydiapneumoniaehasemergedasanimportantcauseofpneumoniainbothadultsandchildrenasyoungas2yearsold.[24,27,30,31]Over50%ofadultsworldwidehaveantibodiesagainstthepathogen,indicatingpriorinfection.Unfortunately,immunityisnotlonglived.Chlamydiapneumoniaehasanincubationperiodof2-4weeks.Thediseaseisusuallymildbutmaybeprolonged.Feverandcougharecommonsymptoms,andchestexaminationusuallyrevealscrackles.[12]AmongpatientswhodevelopC.pneumoniaepneumonia,theillnessisoftenbiphasic,withpatientspresentingwithpharyngitis,thenrecovering,andthendevelopin
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