戴婷+吴昆哲+徐晓华

    [摘要] 回顾性分析吉林大学中日联谊医院肾内科(以下简称“我科”)2016年6～11月收治的4 例布鲁菌病患者的病例资料，探讨布鲁菌病的临床特点，减少误诊误治。结果发现，4例患者均有明确的流行病学接触史，2例发热伴腰痛，1例下肢关节疼痛伴尿频，1例以全身浮肿为主要症状。本组均在我科就诊，1例误诊为双肾结石并发感染，1例误诊为骨关节病，1例误诊为泌尿道感染，1例确诊为肾病综合征。前3例经相应治疗无效，查布鲁杆菌血清凝聚试验阳性，确诊为布鲁菌病，给予利福平、四环素类及左氧氟沙星抗菌药物1～2种治疗后均痊愈。1例放弃治疗，自动出院。布鲁菌病临床表现复杂多变，对发热伴腰痛、关节疼痛的患者，注意详细询问牛、羊等病畜接触史，疑诊者应及时行布鲁杆菌血清学检查，以减少误诊。

    [关键词] 布鲁菌病；误诊；泌尿道感染；肾病综合征

    [中图分类号] R516 [文献标识码] A [文章编号] 1673-7210(2017)05(b)-0160-04

    [Abstract] Clinical data of 4 cases with Brucellosis infection in Department of Nephrology， China-Japan Union Hospital of Jilin University (for short "our department") from June to November 2016 were ret-rospectively analyzed， to investigate the clinical features of brucellosis， less misdiagnosis and mistreatment. The results showed that all the 4 patients had demonstrable epidemiology history， two patients with fever and waist pain， one pain in lower limb joint with frequ-ent urination， one body bloated as the main symptoms. The 4 patients visited at our department at first， and one patient was misdiagnosed as having double kidney stones complicated with infection ......