Text A. Lobular PneumoniaPatient Sm

Text A. Lobular Pneumonia

Patient Smirnov aged 48 was admitted to the hospital with the diagnosis of lobular pneumonia. He had been developing lobular pneumonia gradually. A week before the admission to the hospital he had had bronchitis after which his condition did not improve.

Fever had an irregular course and the temperature changes were caused by the appearance of the new foci of inflammation in the pulmonary tissue. Fever had been persisting for two weeks and had been decreasing gradually.

The patient’s breathing was rapid with 30-40 respirations per minute. There was breathlessness and cyanosis of the face associated with the accompanying bronchitis, decrease in the respiratory surface and occlusion of numerous bronchioles and alveoli.

The patient complained of the pain in the chest particularly on deep breathing in and cough with purulent sputum. The pulse rate was accelerated and the arterial pressure was reduced.

On physical examination dullness in the left lung, abnormal respiration, numerous rales and crepitation were revealed. Dry rales caused by diffuse bronchitis were heard all over the lungs. The liver and spleen were not enlarged. The examination of the organs of the alimentary tract failed to reveal any abnormal signs but the tongue was coated.

The blood analysis revealed leucocytosis in the range of 12,000 to 15,000 per cu mm of blood and an accelerated erythrocyte sedimentation rate (ESR).

The urine contained a small amount of protein and erythrocytes. The X-ray examination of the lungs revealed numerous foci of inflammation of various size, irregular form and different intensity. Shadowing was particularly marked at the root of the left lung due to the enlargement of the lymphatic glands.

It was a severe form of lobular pneumonia which was difficult to differentiate from pulmonary tuberculosis and pleurisy. Yet the physician made a correct diagnosis.

Результаты (китайский) 2:

文字A.小叶性肺炎

48岁的患者横溢考入与小叶性肺炎的诊断医院。他一直在逐步发展小叶性肺炎。在入院他有气管炎，之后他的病情未见好转之前一个星期。

发烧有一个不规则的过程中，温度的变化是由炎症灶新在肺组织的出现引起的。发热已持续两周，已逐渐减小。

该患者的呼吸是迅速的，每分钟30-40呼吸。有呼吸困难，并伴随支气管炎面部紫绀，在呼吸道表面和无数细支气管和肺泡的闭塞减少。

病人的痛苦，在胸部抱怨特别是深呼吸和脓性痰咳出。脉率加快，降低动脉压。

在左肺体检浊音，呼吸异常，众多啰音及捻发音被揭露。引起弥漫性支气管炎干性罗音，听到各地的肺部。肝，脾不肿大。消化道器官的检查，并无发现任何异常迹象，但涂在舌头

的血液分析显示，12000的范围内白细胞增多至15,000血液立方米毫米，加速红细胞沉降率（ESR），

尿含有蛋白质和红细胞的量小。肺部的X光检查发现的各种尺寸，形状不规则和不同强度的炎症病灶无数。遮蔽尤为显着在左肺的根由于淋巴腺的放大图。

这是小叶性肺炎的严重形式，它是很难从肺结核和胸膜炎进行区分。然而，医生做出正确的诊断。