鉴别诊断肺炎时应考虑的一种疾病:FMF

O. Turan, O. Kilinc, S. Acarbay, I. Sari
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引用次数: 2

摘要

家族性地中海热(FMF)是一种很少被认为是肺炎鉴别诊断的疾病。患者女,30岁,因发热、咳嗽、呼吸困难、胸痛入院。根据土耳其胸科学会肺炎指南,该患者作为3B组肺炎住院治疗,因为这组患者同时存在社区获得性肺炎的危险因素和修改因素,不需要重症监护病房,必须住院治疗。(按照“精细计分制度”可归为三类。)尽管抗生素治疗,发烧仍在继续,我们的物理和放射检查没有感染的起源;在尿液、血液和痰培养中也没有发现细菌。当我们调查病人的发热情况时,我们了解到她有多次类似的发热发作,当她发烧时,她有周期性的胸痛和腹痛。我们开始考虑将FMF作为诊断,经过基因检查,在MEFV基因中发现了突变。确诊为FMF。在肺炎的鉴别诊断中应考虑FMF,特别是在地中海社会,如土耳其。
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A disease that should be thought in the differential diagnosis of pneumonia: FMF

One of the diseases that is rarely thought in the differential diagnosis of pneumonia is Familial Mediterranean Fever (FMF). The 30-year-old female patient was admitted to our hospital with fever, cough, dyspnea and chest pain. The patient was hospitalized as group 3B pneumonia according to Turkish Thoracic Society Pneumonia Guideline, as this group of patients have both risk factors and modifying factors for community-acquired pneumonia and have to be treated in hospital without the need of intensive care unit. (It can be classified as class III according to Fine Scoring System.) Fever continued despite the antibiotherapy and there was not an origin of infection with our physical and radiological examinations; also no bacteria were found in the urine, blood and sputum cultures. When we investigated the fever of the patient, we have learnt that she had attacks of fever many times similarly, and when her fever occurred, she had chest and abdominal pain periodically. We started to think about FMF as the diagnosis and after genetic examinations, a mutation has been found in MEFV gene. The patient's diagnosis has been established as FMF. FMF should be thought in the differential diagnosis of pneumonia especially in Mediterranean society, like Turkey.

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