CAJ | 학술논문

结核分支杆菌感染以肺结核最多见，影像学检查表现不典型时容易误诊。该文分析1例肺部及腰椎结核的诊治经过，该例因肺结核表现不典型、结核的常规检查均阴性而未能在入院初立即确诊，其后因进一步完善病史询问及行腰椎MRI发现腰椎结核灶而明确诊断，经积极的抗结核及腰椎手术治疗后，患者好转出院，随访情况良好。通过该例的诊治过程，应明确到，详细的病史询问和体格检查，不完全依赖实验室检查结果而应采用科学的综合的临床思维方法，对正确诊断是非常重要的。
결핵분지간균감염이폐결핵최다견，영상학검사표현불전형시용역오진。해문분석1례폐부급요추결핵적진치경과，해례인폐결핵표현불전형、결핵적상규검사균음성이미능재입원초립즉학진，기후인진일보완선병사순문급행요추MRI발현요추결핵조이명학진단，경적겁적항결핵급요추수술치료후，환자호전출원，수방정황량호。통과해례적진치과정，응명학도，상세적병사순문화체격검사，불완전의뢰실험실검사결과이응채용과학적종합적림상사유방법，대정학진단시비상중요적。
Mycobacterium tuberculosis infection is most common in lung.A misdiagnosis would be made if imaging findings is not typical.Herein we reported one case of lung and lumbar spinal tuberculosis. The patient’s symptoms of tuberculosis were not typical,with negative results of all regular tuberculosis tests, thus a correct diagnosis was not confirmed until further clinical history inquiry and MRI of lumbar spinal was made.The patient was cured after antituberculosis therapy and operation,with good follow-up.From this case, we learned that:detailed clinical history and physical examination as well as scientific thinking,strengthened clinician awareness of atypical tuberculosis infection and a correct understanding of laboratory tests are very im-portant for correct diagnosis.