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男性,26岁,HIV血清学检查阳性。近一周来,活动时出现呼吸困难、呕吐、腹痛、绞痛、食欲不振。体检发现双肺有啰音,心动过速,体温37.9℃。前后位与侧位胸片显示双肺弥漫性间质病变,主要为网状结节型,符合机遇性感染。结节直径2～5mm,边界清楚、无空洞,遍布双肺,以左肺底为著。周围血嗜伊红细胞增多。按卡氏肺囊虫肺炎治疗及抗结核治疗,无效。病人持续低热、呼吸困难。血、尿培养真菌、细菌均为阴性。在大便及支气管肺泡灌洗液中发现
Male, 26 years old, HIV serology positive. In the past week, dyspnea, vomiting, abdominal pain, angina and loss of appetite occurred during the activity. Physical examination found lungs have rales, tachycardia, body temperature 37.9 ℃. Anteroposterior and lateral chest radiograph showed diffuse interstitial lung disease, mainly for the nodular mesh, in line with opportunistic infections. Nodules 2 ~ 5mm diameter, clear boundary, no empty, all over the lungs to the left lung as the base. Peripheral blood eosinophilia. Pneumocystis carinii pneumonia treatment and anti-TB treatment, invalid. The patient continues to have fever and difficulty breathing. Blood, urine culture fungi, bacteria are negative. Found in stool and bronchoalveolar lavage fluid