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Abstract: Cystic fibrosis belongs to a systemic systemic disease that often involves the respiratory system. This 38-year-old Mr. Liu came to our hospital for treatment due to a perennial cough, coughing yellow mucous sputum and recurrent symptoms, and after a series of examinations, he was finally diagnosed with cystic fibrosis. After long-term treatment with drugs for anti-inflammation, anti-infection and sputum dilution, the patient’s cough, sputum and shortness of breath have basically disappeared, and he has slightly increased his weight and is in good mental condition.
Basic information】Male, 38 years old
Disease Type】Cystic fibrosis
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】February 2021
Treatment plan】Intravenous medication (cefoperazone sodium sulbactam sodium for injection, meropenem for injection, ciprofloxacin hydrochloride for injection, erythromycin lactobionate for injection) + oral medication (ambroxol hydrochloride oral solution, azithromycin tablets) + nebulization treatment (tobramycin sulfate injection)
[Treatment period] 2 weeks of hospitalization, regular follow-up after discharge
Treatment effect】Cough, cough and shortness of breath basically disappeared, slight weight gain, good mental status
I. Initial consultation
Patient Mr. Liu, 38 years old, reported that he started to have paroxysmal cough and sputum about 5 years ago, and his sputum was mainly yellow mucous sputum with occasional fever. He was treated with broad-spectrum antibiotics at a local hospital and his symptoms were relieved, but the symptoms recurred within a short period of time. 3 years ago, the patient underwent a chest CT examination at an outside hospital, which showed extensive mixed bronchiectasis in both lungs, emphysema and pulmonary hypertension, and tuberculosis infection was considered. After a CT examination of the chest, the patient showed peribronchial thickening and multiple ground glass shadows, and was admitted to our hospital for further treatment.
(CT: peribronchial thickening)
(CT: peribronchial thickening with multiple ground glass shadows)
II. Treatment history
After admission, the patient underwent several sputum cultures, and the results were Pseudomonas aeruginosa, and the rest of the pathogenic tests had no specific positive results. Subsequently, bronchoscopy was performed on the patient, and a large amount of yellow-white purulent secretion was seen in the nasopharynx, and a large amount of yellow-white purulent secretion was seen in the tracheal lumen. The preliminary diagnosis of pulmonary cystic fibrosis was made by combining the above examinations.
The patient was then given cefoperazone sodium sulbactam sodium for injection, meropenem for injection and ciprofloxacin hydrochloride for anti-infection treatment, erythromycin lactate for injection for anti-inflammatory treatment, and amiloride hydrochloride oral solution for sputum dilution, and hypertonic saline with tobramycin sulfate injection for nebulization to dilute sputum.
III. Treatment effect
After 2 weeks of hospitalization, the patient’s cough and sputum symptoms were significantly reduced, and bronchoscopy was performed again, which showed that the yellow-white purulent secretions in the nasopharynx and organ cavity were greatly reduced, and the discharge criteria were met. After discharge, the patient was instructed to continue nebulization treatment with hypertonic saline and tobramycin sulfate injection, and to continue anti-inflammatory treatment with oral azithromycin tablets. Two months after discharge, the patient came back for follow-up. The patient’s general condition improved significantly, the cough and sputum symptoms basically disappeared, there was no fever during the whole treatment period, no obvious shortness of breath, dyspnea and other discomfort, the patient’s weight increased slightly, the mental status was good, and only a small amount of purulent secretions could be seen on the fiberoptic bronchoscopy.
IV. Notes
We are glad that after a series of active treatment, the patient was finally discharged successfully. However, since the patient was not completely cured at the time of discharge, the following conditions still need to be noted.
1. Patients should be reviewed once a month on time for the first six months after discharge, and if any uncomfortable symptoms such as coughing and shortness of breath occur again during the follow-up period, they should immediately seek medical examination to avoid delaying the diagnosis and treatment of the disease.
2, because the patient’s disease is a consumptive disease, during the treatment period will consume a certain amount of physical strength, so it is recommended that patients should supplement nutrition after discharge, especially to eat more fresh vegetables and fruits, chicken breast, eggs, milk, etc., to supplement high-quality protein as well as vitamins, but avoid high-fat, high-sugar, high-salt diet.
3. The treatment period of this disease is long, so patients should have the patience and confidence to cure, and adhere to the medical prescriptions for medication.
V. Personal insight
Cystic fibrosis is a systemic disease with a variety of clinical manifestations. When the patient’s respiratory system is affected, it often causes cough, sputum, sinusitis and other symptoms, which can usually be effectively cured if detected early and treated in time. If detected late, it often leads to disability or death due to impaired respiratory function. However, it is important to note that the early detection is not the only criterion for the effectiveness of treatment, but the use of the right medication is also important.
In this case, although the time of detection was not particularly early, the patient was treated with effective and sensitive drugs, and the prognosis is still relatively satisfactory.