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患者,女性,35岁,从事蘑菇采摘和培养蘑菇后堆肥的处理工作,工龄3年,不抽烟,既往身体健康。1988年1月,患者感觉头痛、发热、干咳和运动性呼吸困难。同年2月,经检查发现,呼吸变浅、两肺底部有爆裂音。胸透两侧有结节状阴影。P_aO_2为54mmHg,P_aCO_2为33 mmHg,血液pH值为7.43。经支气管肺组织活检发现有淋巴细胞浸润和肉芽肿形成。支气管肺泡洗出液细胞总数为3.7×10~7个/ml,78%为淋巴细胞,CD 4/CD 8为0.28。痰培养为正常菌丛,未发现真菌。入院
Patient, female, 35 years old, engaged in the compost treatment after mushroom picking and cultivation of mushrooms, 3 years of service, no smoking, previous good health. January 1988, the patient feels a headache, fever, dry cough and dyspnea. In the same year in February, the inspection found that breathing shallow, bottom of the lungs have crackles. Chest throat on both sides of the nodular shadow. P_aO_2 was 54 mmHg, P_aCO_2 was 33 mmHg, and blood pH was 7.43. Bronchial lung biopsy found lymphocytic infiltration and granuloma formation. The total number of bronchoalveolar lavage fluid cells was 3.7 × 10-7 cells / ml, 78% were lymphocytes, and CD4 / CD8 was 0.28. Sputum culture for the normal flora, no fungi found. Admission