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粟粒结核病临床并不少见。因本病系血行播散而发病,故早期少有咳嗽、咯痰等呼吸道症状。痰涂片及培养检查,结核菌常阴性。唯一的主诉多是发热。胸片表现为粟粒状阴影,与肺转移癌、弥漫性细支气管炎、尘肺、结节病、过敏性肺炎等疾病常难鉴别。以前对本病的确诊,多依赖肝脏活检,然而,干酪或非干酪样的肉芽性病变也可见于布鲁氏菌病、铍中毒、组织胞浆菌病、结节病、梅毒等,故诊断价值也不高。作者对9例粟粒结核作结核菌素试验,4例阳性,
Miliary tuberculosis is not uncommon in clinical practice. Due to the disease spread of blood and pathogenesis, it is rare early cough, expectoration and other respiratory symptoms. Sputum smear and culture tests, tuberculosis often negative. The only chief complaint is fever. Chest radiography showed miliary shadows, and lung metastases, diffuse bronchiolitis, pneumoconiosis, sarcoidosis, allergic pneumonia and other diseases often difficult to identify. Previous diagnosis of the disease, and more dependent on liver biopsy, however, cheese or non-caseous granulomatous lesions can also be found in brucellosis, beryllium poisoning, histoplasmosis, sarcoidosis, syphilis, so the diagnosis Value is not high. The author of 9 cases of miliary tuberculosis tuberculin test, 4 cases of positive,