Clinical analysis on a case of occupational stage Ⅲ silicosis combined with pulmonary tuberculosis and aspergillosis / 中国职业医学

ABSTRACT

OBJECTIVE: To analyze the clinical characteristics and diagnosis of silicosis with pulmonary tuberculosis and pulmonary aspergillosis. METHODS: The clinical data of a case of silicosis combined with pulmonary tuberculosis and aspergillosis was analyzed retrospectively. RESULTS: The clinical symptoms of this patient were chest tightness, suffocation, cough, expectoration and hemoptysis. The patient was diagnosed as tuberculosis in the local hospital in 2015. Two previous sputum smears of the patient were positive for mycobacterium tuberculosis. Both qualitative analysis of blood tubercle bacilli and sputum smear examination of acid-fast bacilli were negative. Chest computed tomography(CT) showed right lung pneumoconiosis with large shadow, left lower lobe of lung with uneven density and flake shadow, low density necrotic foci, a cavity with smooth wall. Sputum fungal culture: Aspergillus fumigatus(+++); bronchoscopic lung biopsy showed: Aspergillus pneumoniae. CONCLUSION: Low immunity, malnutrition and long-term use of antibiotics and hormones are the high risk factors of pulmonary aspergillosis. It is helpful to combine laboratory examination, patients′ clinical manifestations and chest CT characteristics, and to analyze the condition comprehensively for the early diagnosis of silicosis with pulmonary aspergillosis.