Symptom, physical sign, X-ray of pulmonary tuberculosis,etc. display and mix with many kinds of respiratory tracts and whole body diseases. It is more typically to display it and not if you can't lack by bacteriology or pathology, make a definite diagnosis of according to when easy to be misdiagnose. Need, inquire medical history conscientiously often, make, check while being corresponding, analysis carefully, finish differential diagnosis to reduce by mistake, leaks and examines. It is lung cancer, pneumonia, lung abscess that most often need to distinguish, prop up, prop up expanding, generating heat disease slowly.
First, lung cancer
There is a tubercle shadow or have mediastinal lymph nodes of lung door to shift at lung door in the centre type, need to distinguish with lymphocytic tuberculosis; There are small soaking, tubercles around the lung around type, need to soak the cooking stove of venereal disease to distinguish with tuberculosis ball or tuberculosis. Lung cancer is mostly over 40, the centre type takes scale's cancer as the core, often smoke in the history for a long time, seldom have a fever, have difficulty in breathing or the chest uncomfortable in chest aches and aggravates gradually, often the irritation coughs, has blood of phlegm, person who go on become thin, person who shift can touch the intersection of quality and hard lymph node on have clavicular, some patient can have the intersection of bone and loose to solicit joint. X Line tubercle can divide the burr of the leaf, without cooking stove of satellites, generally there is no calcification, there can be vacuole to solicit; The periphery type can be seen and fall into and solicit in the pleura. Phlegm the intersection of 70 and the intersection of person who can examine and cancer cell but T B can 50 find the intersection of tuberculosis and fungus. Fine to prop up mirror, examine centre type, can see new living beings, can obtain pathological diagnosis to examine often while living, can find the cancer cell while brushing slice, B A L, the tuberculosis person can find T B. Form, test often negative lung cancer usually and tuberculosis is often strong and positive. It is often positive that E L I S A law checks serum P P D - I gG or L A M - L gG tuberculosis. And serum saliva acid determine as C E A (+) ,Often brief on cancer. Should cut open the chest to ascertain when the above-mentioned several can't make a definite diagnosis of. If there is active indication of more tuberculosis, for instance: Phlegm P C R law T B - D N A is positive, form strong and positive or 0 plain 1u. 1 U is positive generally or I gG or I gG L A M E L I S A law P P D (+) Can try resisting the tuberculosis treatment to observe in order to distinguish.
Second, pneumonia
The lung is non- bacterial ' Mycoplasma, virus, irritation) Often reveal the patch shadow is similar to manifestation of soaking pulmonary tuberculosis in early days, and bacterial pneumonia but mixes with tuberculosis pneumonia of cheese when presents big leaf pathological change, need to distinguish. Pneumonia often symptom light mycoplasma and the X-ray weighs, disappear by oneself in 2-3 weeks; Anaphylaxis person acidophil increase in the blood, shade visit person who walk in the lung, have characteristic to be easy to distinguish each. Bacterial pneumonia can get up the intersection of disease and anxious, shiver with cold, hyperpyrexia, cough ferruginous phlegm, it there is be bleb phlegm T B (-) ,The pneumonia streptococcus is positive, the antibiotic treatment can resume fast,
Soaking pulmonary tuberculosis if has cavities to often need to distinguish with lung abscess, a section of tuberculosis cavity of following apex needs to distinguish with acute lung abscess particularly, the slow fine hole type needs to distinguish with chronic lung abscess. Distinguish whether lie in some mainly,tuberculosis phlegm T B (+) ,Lung abscess ' -),Lung abscess get up disease to be relatively worried, leucocyte total number and neutral grains of cell increase, antibiotic result obvious, but the tuberculosis cavity can be continued and taken place the bacterial infection, T B difficult detection in the phlegm at this moment sometimes.
Fourth, chronic bronchitis
Often similar to slow fine hole patient's symptom, but X-ray and phlegm fungus are easy to distinguish to check. Prop up the patient X-ray rarely seen lamination to changes and has not seen the essence T B cooking stove slowly, but the slow fine hole person has clear serious pathological changes, and T B (+) .
Fifth, bronchiectasis
Symptom, in order to cough, cough the phlegm of suppuration, spit blood repeatedly, the easy and slow fine hole is mixed, but or curly hair shadow that the X-ray general rarely seen lamination is thick and messy.
Sixth, other, with disease that generate heat
Acute the intersection of millet and grains of tuberculosis reduce kinds of leukemia with hyperpyrexia, the intersection of liver and splenomegaly, leucocyte kind react with typhoid fever and septicaemia, leukemia display have, mix, need distinguishing carefully according to each characteristic. Adult's bronchus lymphocytic tuberculosis generates heat to mix with apt and mediastinal lymphoma of enlargement of lymph nodes of lung door, tubercle, can distinguish by forming usually testing, serum P P D - I gG checking, such methods as A C E determining, K veim tests, lives and examines, can the anti-tuberculous drug treatment observe if necessary. Tuberculosis and tumour should use anti-tuberculous drug first while distinguishing, it should be after employing anti-tuberculous drug if there is hormone, in case that the interference is diagnosed and cause and sow scatteredly.
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