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Abstract: A 34-year-old female patient presented to our hospital with cough and sputum for 1 month, malaise, low-grade fever, and night sweats for 2 weeks. After understanding that the patient had symptoms such as dizziness, dry cough, and difficulty in coughing sputum after strenuous exercise, auxiliary examinations were performed, and the results returned a significant increase in blood sedimentation and C-reactive protein, and the sputum smear was positive for antacid bacilli, suggesting Mycobacterium tuberculosis infection, and the patient was diagnosed with pulmonary tuberculosis. After 6 months of treatment, the patient was clinically cured.
Basic information】Female, 34 years old
Type of disease】Respiratory tuberculosis (pulmonary tuberculosis)
Hospital】The Second Hospital of Harbin Medical University
Date of consultation】December 2019
Treatment plan】Oral medication (isoniazid tablets, rifampin capsules, pyrazinamide tablets, ethambutol hydrochloride tablets) + intravenous drug infusion therapy (isoniazid injection, rifampin for injection)
[Treatment period] 6 months of treatment
【Treatment effect】 Achieve clinical cure
I. Initial consultation
A 34-year-old female patient came to our hospital with cough and sputum for 1 month, weakness, low fever and night sweats for 2 weeks. When we first saw the patient, she was thin and in poor mental condition. One month ago, the patient had dizziness, dry cough and difficulty in coughing in the morning on the second day after strenuous exercise at night, and thought it was a common cold, so he did not pay attention to it.
The patient further inquired about his past history and family history. The patient reported that he was in good health, but his mother had tuberculosis, which had been cured. The patient was given a CT lung examination, which revealed a mass in the lung.
II. Treatment history
After admission, the patient was further improved with ancillary examinations, including routine blood, liver function, blood lipids, sedimentation, C-reactive protein, tuberculin test, sputum smear for antacid bacilli, sputum bacterial culture, fungal smear, and fungal culture. The results of tuberculin test showed a strong positive result, sputum smear for antacid bacilli was positive, blood sedimentation and C-reactive protein were significantly increased, but other results were not significantly abnormal. The patient’s sputum smear was positive for Mycobacterium antacidum, suggesting Mycobacterium tuberculosis infection, and the diagnosis of pulmonary tuberculosis was made.
After clear diagnosis, according to the treatment principle of pulmonary tuberculosis, drug therapy was selected and the patient was given isoniazid tablets, rifampin capsules, pyrazinamide tablets and ethambutol hydrochloride tablets for 2 months followed by isoniazid injection, rifampin for injection intravenous infusion and combined chemotherapy for 4 months.
III. Treatment effect
As the patient actively cooperated with the treatment, the overall treatment effect was better. After 5 days of treatment, the malaise, hypothermia, night sweats and other uncomfortable symptoms were significantly improved, and the patient’s body temperature was stabilized in the normal range. After 2 weeks of drug treatment, the patient’s symptoms of dry cough and difficult coughing sputum improved, the weakness of the limbs was relieved, the symptoms of easy sweating improved, and the results of blood sedimentation and C-reactive protein turned to normal when all auxiliary tests were rechecked.
After 2 months of continuous treatment, the patient’s general condition improved, and the sputum smear result of antacid bacillus became negative, and the lung CT result showed that the scope of the lesion was reduced, and his mental outlook was greatly improved. At this time, he was switched to intravenous infusion of isoniazid injection and rifampin for injection for combination chemotherapy. After 4 months of combined chemotherapy, the patient’s lung CT results showed that the lesions disappeared, and the sputum smear for antacid bacillus results turned negative and did not return positive again, and the patient had no other discomfort and reached the standard of clinical cure.
IV. Notes
We are glad that the patient was clinically cured of tuberculosis after active treatment. However, since the disease is easily recurring, patients should pay attention to the following points in their daily life for the sake of their health.
1. in daily life, pay attention to keeping warm to avoid respiratory diseases, pay attention to personal hygiene in general, wear a mask when going out, do not spit anywhere, and keep air circulation in the room.
2, patients should be appropriate physical exercise according to their own situation, to enhance physical resistance, avoid strain, stay up late, but also quit smoking, regular rest and rest.
3, in terms of diet, patients should pay attention to adequate nutrition, avoid partial diet, it is recommended that a balanced intake of cereals, legumes, vitamins, dietary fiber and other foods, while eating fresh vegetables and fruits.
V. Personal insight
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis infection, which is more common in clinical practice and is mostly transmitted by droplets. In this case, the patient had a history of exposure to tuberculosis because his mother had tuberculosis, but at that time, the immunity of the organism was probably strong and the disease did not develop at that time. In this case, it is possible that after the patient’s strenuous exercise, the resistance of the body was weakened, and the Mycobacterium tuberculosis hidden in the patient’s body started to cause the disease.
The main treatment for tuberculosis is through anti-tuberculosis drugs, but there are major or minor adverse reactions to anti-tuberculosis drugs, such as gastrointestinal reactions and liver damage. Therefore, when using drugs to treat tuberculosis, it is important to closely observe the patient’s condition, and prompt medical consultation is recommended in case of abnormalities.