摘要
目的提高病理医师对组织胞浆菌病(Hp)和球孢子菌病(Cd)的认识,提高及时诊断的概率。方法回顾1例Hp和1例Cd的诊治过程,并复习文献。结果 Hp和Cd常首先表现为肺部单发或多发结节性病灶,很似结核,附近淋巴结常被波及,临床有发热、咳嗽、咳痰及血象偏高等。经真菌培养和活检可确诊。结论 Hp和Cd由于少见而易误诊,甚至发生全身性播散而导致病情加重。诊断的关键是考虑到此病,尤其是对发热、咳嗽、咳痰、抗炎治疗无效者。病理要密切联系临床,并以高倍镜和油镜仔细观察,PAS等染色常可发现典型的病原体。
Purpose： To enhance the knowledge in histoplasmosis （Hp） and coccidioidosis （Cd） infected disease. Methods The diagnosis and treatment were investigated in 1 patient of Hp infection and 1 patient of Cd infection, with review of the literatures. Results Hp and Cd infected patients always showed single mass or multi-mass in the lung firstly and misdiagnosed as tuberculosis. The lymph node was usually involved. Clinically, the patients had fever, cough and expectoration. Neutrophils in blood were usually high. Fungus culture and biopsy could confirm the diagnosis. Conclusion The co-infection of Hp and Cd is so rare and as lack of knowledge it is easy to delay and miss the diagnosis. And sometimes the patient has a severe result of disseminated systemic illness. The diagnosis of this disease should be considered for the patients with fever, cough and sputum that anti-inflammatory treatment is not effective. Pathologists need to closely correlate to clinical findings and to carefully observe the lesion with oil and high power microscope, and PAS staining may help to demonstrate the typical pathogens.
出处
《诊断病理学杂志》
CSCD
2010年第5期328-331,335,共5页
Chinese Journal of Diagnostic Pathology
