Clinical Thinking Ability and Dynamic Observation of Pathogenetic Condition are the Key to the Differential Diagnosis - Clinical Analysis of Community-acquired Pneumonia of Suggested Pulmonary Tuberculosis by Pathological Examination
I Kong-Shou
AO Ri-ying
Abstract：Objective To summarize experiences of the clinical manifestations in discrepancy with pathological exam-ination in terms of the elderly community-acquired pneumonia ( CAP) to improve diagnosis and treatment in order to reduce misdiagnosis and mistreatment rates. Methods Clinical data of 1 case of CAP of suggested pulmonary tuberculosis by patho-logical examination were retrospectively analyzed. Results The patient was admitted for cough, sputum, fever, fear of cold and chill for 10 d, blood leukocyte was 18. 5 × 109/L, neutrophils was 0. 952, CRP was 150 mg/L, original calcitonin was 1500 ng/L. Chest CT examination showed a shadow of consolidation of the lung, fuzzy boundaries, and the patient was sus-pected as having CAP. The patient's symptom improved after one week of anti-infection treatment, but chest CT examination showed that the focus was expanded. Percutaneous lung biopsy suggested pulmonary tuberculosis. The anti-tuberculosis treat-ment was not given. The patient was discharged 13 d after anti-infection treatment. After a follow-up of 6 months after treat-ment, chest CT examination showed that the focus was completely absorbed. No relapse occurred during the 18 month- fol-low-up and the patient was confirmed as having CAP. Conclusion Pathologic examination result is authoritative, but in case of discrepancy between clinical manifestations and pathological findings, clinicians should not depend too much upon patholog-ical examination results. Comprehensive analysis combined with clinical situation, and observation of the dynamic change should be carried out to avoid misdiagnosis and missed diagnosis.
Keywords：PneumoniaAgedPathologyclinicalMisdiagnosisTuberculosispulmonary
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 62-65 )