每日一题_2023.08.27

A 25-year-old medical student presents to the clinic with a nonproductive cough, low-grade fever, and malaise of three weeks’ duration. A few friends in his study group have been feeling the same way. Sputum cultures are negative. The patient denies exposure to farm animals, travel, or HIV. The physician treats for an atypical pneumonia. Which of the following methods could help identify the organism responsible for this most likely causative pathogen?

一名25岁的医学生因干咳、低热和持续3周的不适到诊所就诊。他学习小组里的几个朋友也有同样的感觉。痰培养呈阴性。患者否认接触过家畜、旅行或艾滋病毒。医生在治疗一种非典型肺炎。下列哪个方法可以帮助识别生物负责这个最有可能的病原?

(A) Acid-fast stain抗酸染色

(B) Cold agglutinin testing冷凝凝集素试验

(C) Gram stain革兰染色

(D) India ink stain墨汁染色

(E) Serum polymerase chain reaction血清聚合酶链反应

答案解析：

对于隐匿起病的干咳、低热、头痛、肌痛、恶心或呕吐患者，应考虑非典型肺炎。非典型肺炎多由支原体或病毒引起。支原体不能培养，只能通过冷凝集素试验来检测，冷凝集素试验测定免疫球蛋白冷却后的凝集。胸部x线检查往往比体格检查结果更令人印象深刻，其特征是斑片状间质型。治疗包括5天的大环内酯类抗生素治疗，通常是阿奇霉素。

正确答案：B