The differential diagnosis of tuberculosis

TB symptoms and signs, X-ray and other performance and a variety of respiratory and systemic diseases mixed. In a typical performance and the lack of bacteriological or pathology, according to confirmed easily misdiagnosed. So often asked to be serious history, for the corresponding inspection, a detailed analysis, the differential diagnosis can be made to reduce errors, missed. Identification is required in most lung cancer, pneumonia, lung abscess, chronic bronchitis, branch expansion, febrile disease.

First, lung cancer: central hilar Department nodules in the video or hilar lymph node metastasis, and the need to identify the lymph nodes; peripheral lung around in a small-invasive, nodules, takes the ball with TB lesions or invasive identification of TB . Lung cancer for more than 40 years old and above, the main centre of the squamous cell carcinoma, often long-term smokers, is generally not a fever, difficulty breathing or chest tightness, chest pain more severe, often irritating cough, sputum blood, sexual thinner, Clavicle on the transfer of hard to reach lymph nodes, some patients will have bone and joint mast levy. X-ray nodules can有分of Burr, a satellite kitchen, no calcification in general, can levy a cavity; peripheral that pleural invagination of the levy. Sputum 70 percent in the cancer cells can be seized and 50 percent of TB can be found tuberculosis. Bronchoscopy that the seizure of new biotechnology center, often for biopsy diagnosis, brush-chip, BAL cells can be found, TB can be found TB. Node-negative test lung cancer and tuberculosis are often strong positive. ELISA method investigation serum PPD-IgG or LAM-LgG TB often positive. Sialic acid and serum CEA determination, often prompted to cancer. All these can not be confirmed thoracotomy exploration. For more indications of tuberculosis activities, such as: PCR method smear-positive TB-DNA, a guitar-1 u strong positive or 0.1 u generally positive or PPD-IgG ELISA method or try LAM-IgG anti-tuberculosis treatment observation for identification .

Second, pneumonia: the lungs of non-bacterial plaque films often show early invasive and video performance similar to tuberculosis, bacterial pneumonia and a big leaf diseases and tuberculosis can be mixed cheese pneumonia, must be identified. Mycoplasma pneumonia symptoms often Qinger X-ray-2-3 weeks to disappear; allergic to blood eosinophil increased migration of the shadow of the lungs, have different features easy to identify. Bacterial pneumonia can be acute onset, chills, high fever, cough rust colored sputum, lips herpes and sputum TB, and lung abscess, lung abscess more acute onset, WBC and the total number of neutrophils increased antibiotic effect obvious, but sometimes Tuberculosis can be empty secondary bacterial infection, not at this time sputum TB detection.

4, chronic bronchitis: often slow and defibrillators in patients with symptoms similar to hole, but X-ray and sputum examination easy identification. Chronic bronchitis patients with X-ray only see no real change in texture TB lesions, and the slow-defibrillators are a clear serious diseases, and TB.

5, bronchiectasis: symptoms of cough, cough Nongtan, repeated hemoptysis, easy and slow-fiber mixed, but generally only see X-ray texture rough chaos or curling video.

6, the other with fever disease: acute miliary tuberculosis to high fever, liver and spleen, leukopenia or type of leukemia-like reaction, and typhoid fever, sepsis, leukemia mixed performance, the need to carefully identify their own characteristics. Adult bronchial lymph nodes nuclear fever and hilar lymph nodes easily and mediastinal lymphoma, sarcoidosis mixed, guitar-available test, serum PPD-IgG inspection, ACE determination, Kveim tests, biopsies and other identification methods, if necessary, anti - Treatment of tuberculosis drugs. Tuberculosis and Tumor identification at the Yixian use of anti-tuberculosis drugs, hormones should be if the application of anti-tuberculosis drugs, so as not to interfere with the diagnosis and disseminated.