竹签意外刺入胸腔引发的肺炎、多发肺梗塞和肺脓肿：一例误诊为肺结核的病例报告

瞿鹏飞; 白宝良; 段婷; 刘凯; 杜进良; 熊鑫; 贾彭林; 孙仲春; 雷普平

doi:10.24920/003782

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竹签意外刺入胸腔引发的肺炎、多发肺梗塞和肺脓肿：一例误诊为肺结核的病例报告

中国医学科学杂志（英文版） 2021年36卷第3期页码：252-256

病例报告 | Updated：2024-04-10

- 竹签意外刺入胸腔引发的肺炎、多发肺梗塞和肺脓肿：一例误诊为肺结核的病例报告
- Affiliations：
  
  1. 1School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
  2. 2Criminal Science and Technology Office, Jinping County Public Security Bureau, Honghe Hani and Yi Autonomous Prefecture, Yunnan 661500, China
  3. 3Department of Pathology, School of Basic Medicine, Peking University Health Science Center, Beijing 100083, China
- Author bio：
  
  *Tel: 86-0871-65922659; E-mail: puping.jacky@qq.com
- Funds：
  
  This study was supported by the National Natural Science foundation of China;国家自然科学基金(81460285)
- DOI：10.24920/003782
  中图分类号：
- 收稿日期：2020-05-10，
  
  录用日期：2020-9-15，
  
  纸质出版日期：2021-08-09
- Accepted：
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瞿鹏飞, 白宝良, 段婷, 等. 竹签意外刺入胸腔引发的肺炎、多发肺梗塞和肺脓肿：一例误诊为肺结核的病例报告[J]. 中国医学科学杂志（英文版）, 2021,36(3):252-256.

Qu Pengfei, Bai Baoliang, Duan Ting, et al. Pneumonia, Multiple Pulmonary Infarction and Abscess Caused by a Bamboo Stick Accidentally Piercing into Chest: a Case Misdiagnosed as Pulmonary Tuberculosis[J]. Chinese medical sciences journal, 2021, 36(3): 252-256.
瞿鹏飞, 白宝良, 段婷, 等. 竹签意外刺入胸腔引发的肺炎、多发肺梗塞和肺脓肿：一例误诊为肺结核的病例报告[J]. 中国医学科学杂志（英文版）, 2021,36(3):252-256. DOI： 10.24920/003782.

Qu Pengfei, Bai Baoliang, Duan Ting, et al. Pneumonia, Multiple Pulmonary Infarction and Abscess Caused by a Bamboo Stick Accidentally Piercing into Chest: a Case Misdiagnosed as Pulmonary Tuberculosis[J]. Chinese medical sciences journal, 2021, 36(3): 252-256. DOI： 10.24920/003782.

摘要

计算机断层扫描（CT）检查是发现和诊断体内异物的主要手段。CT对异物的诊断虽然具有较高的敏感性

但仍有一些干扰因素可能导致漏诊或误诊。我们报告一个罕见的案例。一青年男性被一根竹签意外地刺入左胸。由于特殊原因

该竹签一直残留胸腔三年而未被发现。患者初以咳嗽、胸痛、发热、咯血在当地医院多次住院诊治

痰涂片未检出结核杆菌

胸部CT检查发现左肺结节、双肺粟粒状及空洞阴影

临床先后诊断为原发性肺结核及继发性肺结核。3年间他接受抗结核治疗

但症状未见改善。直到去世前一个月

在另一家医院通过螺旋CT检查和三维重建发现胸腔内这根竹签异物。尸体解剖检验确认死因为肺炎、肺梗死和多发肺脓肿。本文分析了该病例误诊的因素

旨在为临床中异物合并肺部炎症的诊断和治疗提供参考。

Abstract

Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body

some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough

chest pain

fever

hemoptysis

and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital

although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years

but no improvement of his symptoms was observed. Until one month before his death

the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia

pulmonary infarction

and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case

aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.

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