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患者,女,48岁,农民,以间断发热半年,咳嗽、咯痰1月,咯血6h主诉二次入院。半年前因受凉出现发热,T37.5～38.5℃,无咳嗽、咯痰,自服感冒退热药无效,门诊拍胸片提示:左下肺炎,给予静点妥布霉素24万U×10d,体温好转。1月前再发高热,寒战,T39℃以上,伴阵咳,咯白痰,首次收住院,复查胸片、CT怀疑左下肺外后段占位病变可能,于纤支镜下可见左下肺外后段开口被一瘤体样肿物完全堵塞、质地柔韧,活检出血不多,病理报告未见瘤细胞,提示炎性改变,继续给予抗感染、止咳祛痰等对症治疗2周自动出院。之后口服阿莫西林约3周,咳嗽、咯痰时轻时重,伴左胸隐痛,体温趋于正常。6h前因重体力劳动后突然咯血约500ml,急诊再次收住院。自发病以
Patients, female, 48 years old, peasants, intermittent fever for six months, cough, expectoration January, hemoptysis 6h complained of secondary admission. Six months ago due to cold appear fever, T37.5 ~ 38.5 ℃, no cough, expectoration, self-service flu antipyretics invalid, outpatient shot chest X-ray prompt: left lower pneumonia, intravenous injection of tobramycin 240,000 U × 10d, Body temperature improved. 1 month ago issued a high fever, chills, T39 ℃ above, with array cough, slightly Phlegm, admitted to the hospital for the first time, review chest radiograph, CT suspect posterior left lower lung space occupying lesion may be seen under the bronchofibersopus left lung Posterior segment was completely blocked by a tumor-like mass, flexible texture, small amount of biopsy, pathological report no tumor cells, suggesting that inflammatory changes continue to give anti-infective, cough expectorant and other symptomatic treatment of 2 weeks to be discharged automatically. After oral amoxicillin for about 3 weeks, cough, expectoration light weight, with left chest pain, body temperature tends to be normal. 6h ago due to heavy manual labor after hemoptysis about 500ml, emergency again admitted to hospital. Self-onset to