肺类melidosis误诊为肺结核

Chandan Kumar Sheet, Saibal Ghosh, Subhankar Chatterjee, Biplab Chandra
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引用次数: 0

摘要

是一种兼性革兰氏阴性腐生菌,常见于土壤或受污染的水中,可引起类melidosis。类鼻疽因其异质的临床表现和不同的器官受累而与其他疾病相似。由于它的多功能性,它被称为“伟大的模仿者”,诊断仍然具有挑战性。我们报告一例被误诊为肺结核的类鼻疽病。54岁男性,不吸烟,有糖尿病病史,因持续咳嗽、呼吸困难、咯血5个月入院。最初有胸膜炎性胸痛和高烧。痰液AFB和结核分枝杆菌基因专家检查均阴性,但根据临床症状和影像学表现,多次在当地医院静脉注射广谱抗生素和抗结核治疗。胸片示多发厚壁腔伴腔周实变及斑片状浸润性混浊。确定了half文化。采用抗生素敏感性试验解决呼吸道疾病。本病例研究描述了一例患有糖尿病并从事农业的成年男性类鼻疽,其临床表现多样且不明确,与许多其他疾病相似。通过支气管镜检查收集的培养物进行分离,明确诊断。
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Pulmonary melioidosis misdiagnosed as pulmonary tuberculosis
is a facultative Gram-negative saprophytic bacterium commonly found in soil or contaminated water causing melioidosis. Melioidosis can mimic various other disease due to its heterogenous clinical manifestations and different organ involvement. Because of its versatility it is called as “the great imitator” and remains challenging to diagnose. We report a case of melioidosis misdiagnosed and treated as pulmonary tuberculosis. A 54-year-old male non-smoker with history of diabetes admitted with persistent cough, breathlessness and hemoptysis for 5 months. Initially there was pleuritic chest pain and high-grade fever. He was treated with multiple intravenous broad-spectrum antibiotics and anti-tubercular therapy multiple times in the local hospitals based on clinical symptoms and radiological manifestation though Sputum examination for AFB and Gene xpert for Mycobacterium tuberculosis was negative. Chest radiology showed multiple thick-walled cavities with pericavitary consolidation along with patchy infiltrative opacities. BALF culture identified . The respiratory morbidity was resolved using antibiotics based on antibiotic susceptibility tests. This case study described a case of melioidosis in adult male with diabetes and engaged in farming presented with diverse and indistinct clinical manifestations that mimics many other diseases. Definitive diagnosis was made by isolation , in culture collected through bronchoscopic examination.
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