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目的探讨蠊缨滴虫肺部感染的临床表现,以提高对这一疾病的认识与明确诊断和有效治疗手段。方法分析温州医学院附属第一医院确诊的2例蠊缨滴虫肺部感染的病例资料,结合文献报道的119例资料进行文献复习。结果 2例患者中,1例无基础疾病,另1例为血液系统肿瘤化疗后;2例均表现为发热伴咳嗽,胸部CT示肺部渗出、实变、结节及胸腔积液,2例经多种抗菌药物治疗均无效,支气管肺泡灌洗液镜检明确诊断,最终甲硝唑治疗有效;文献报道的病例症状轻重差异较大,可有发热、咳嗽、呼吸困难,血嗜酸粒细胞升高,影像学表现多样;痰液和支气管肺泡灌洗液直接涂片检查是明确病原体的方法。结论肺部蠊缨滴虫感染可发生在免疫功能正常及免疫功能低下的患者,临床表现缺乏特异性,支气管肺泡灌洗液镜检是明确诊断蠊缨滴虫肺部感染的重要手段。
Objective To investigate the clinical manifestations of pulmonary infection of Trichomonas vaginalis in order to improve the understanding of the disease and confirm the diagnosis and effective treatment. Methods Two cases of pulmonary infection of T. cockroach were diagnosed in the First Affiliated Hospital of Wenzhou Medical College. The literatures reviewed 119 cases with literature review. Results Of the 2 patients, 1 had no underlying disease and 1 had hematologic malignancy after chemotherapy. Both showed fever and cough, chest CT showed pulmonary exudation, consolidation, nodules and pleural effusion, 2 Cases by a variety of antimicrobial agents were ineffective, bronchial alveolar lavage fluid microscopy confirmed the diagnosis, the final metronidazole treatment effective; reported cases of severe differences in symptoms, may have fever, cough, dyspnea, blood eosinophils Cells increased, imaging performance varied; sputum and bronchoalveolar lavage direct smear examination is a clear pathogen. Conclusion The infection of T. cockroach in the lung can occur in patients with normal immune function and immunocompromise. The clinical manifestations are not specific. The bronchial alveolar lavage fluid microscopy is an important method to diagnose the pulmonary infection of T. cockroach.