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患者,男性,40岁。于1982年4月6日突然大咯血,一日十余口,伴乏力,低热,咳少量黄稠痰,无臭,咳嗽不剧右下胸痛,深呼吸时加剧。次晨痰液中有少许黄白色颗粒,取颗粒压碎后在显微镜下观察为交织的分枝状菌丝直径约lum,末端呈放射状,革兰氏染色阳性。抗酸性染色阴性。接种血琼脂平板于厌氧环境下孵育三天,见有蜘蛛样菌落生长,一星期后菌落隆起,表面粗糙呈臼齿状。有氧环境中未见该菌生长,亦未分离出其他致病菌。将厌氧环境生长的菌落移种于沙包氏液体培养基,厌氧环境下孵育三天后,在培养基表面下lcm处见有絮团状生长物,镜检为革兰氏阳性分枝状菌丝(图1)。糖发酵试验及其它生化反应均符合以色列放线菌特征。患者既往健康,无烟酒嗜好,家属史无特殊。
Patient, male, 40 years old. On April 6, 1982 sudden massive hemoptysis, more than ten days a day, with fatigue, fever, cough a small amount of thick yellow sputum, odorless, cough not right lower chest pain, deep breath intensified. The next morning sputum with a little yellow-white particles, take the particles crushed under a microscope for the cross-woven mycelial diameter of about lum, the end was radial, Gram staining. Acid-resistant stain negative. Inoculated with blood agar plate in anaerobic environment for three days, see spider-like colonies grow, a week after the colonial uplift, the surface rough molars. Aerobic environment no bacteria growth, nor isolated from other pathogens. The colonies grown in anaerobic environment were transplanted in sandbags liquid medium. After three days of incubation in anaerobic environment, flocculent growth was observed at lcm below the surface of the culture medium. Microscopy was Gram-positive mycobacterium Silk (Figure 1). Sugar fermentation test and other biochemical reactions are in line with the characteristics of Actinomyces Israel. Past health of patients, non-smoking alcohol hobby, no special family history.