每日一题_2023.09.14

A 51-year-old man from the Democratic Republic of Congo presented to the emergency department with a 1-week history of small-volume hemoptysis. Sixteen months before presentation, computed tomography (CT) of the chest had shown a right upper lung cavitation that was a sequela of treated pulmonary tuberculosis (top). At the current presentation, a repeat CT of the chest showed thickening of the wall of the right upper lung cavitation and a new intracavitary mass (bottom). Which of the following agents may be used in the management of this condition?

来自刚果民主共和国的一名51岁男性因少量咯血1周到急诊科就诊。就诊前16个月，胸部计算机断层扫描(CT)显示右上肺空洞，这是肺结核治疗后的后遗症(上图)。此次复查胸部CT示右上肺空洞壁增厚，腔内(底部)新发肿块。下列哪一种药剂可用于这种情况的管理?

A. Azithromycin 阿奇霉素

B. Rifampin 利福平

C. Rituximab 利妥昔单抗

D. Trimethoprim-sulfamethoxazole 甲氧苄氨嘧啶

E. Voriconazole 伏立康唑

答案解析：

患者血清样本曲霉菌特异性IgG抗体阳性后被诊断为肺曲菌球。通过质谱鉴定烟曲霉。并发结核病被排除。开始伏立康唑治疗。在制定肺叶切除术计划之前，患者失访。14个月后，患者出现大咯血，并接受了肺动脉栓塞术。

正确答案：E