关键词: 肺炎, 结核,肺/诊断, 误诊

Abstract: Objective To understand the factors that influence pneumonia patients to be misdiagnosed as pulmonary tuberculosis.Methods Retrospective analysis of 57 Cases of pneumonia who were misdiagnosed as pulmonary tuberculosis.Results The misdiagnosis rate was 22.3%（57/256）.Their clinical symptoms were as follow: 28% had sweats at night,56% had fever in the afternoon,17.5% hemoptysis.59.6% showed the pathological changes in the chest X-ray photos,which located in the apical and rear segments of the upper lobes or the superior segments of the lower lobes.Routine blood test showed that 64.9% patients’ WBC were 4.0×10⁹～10.0×10⁹/dl and 14% sputum cultures were positive.Conclusions （1） Cause of misdiagnosis: The clinical symptoms were atypical,chest X-ray appearance and routine blood test Results of pneumonia patients were difficult to differentiate with pulmonary tuberculosis.（2） Preventive interventions: The patients with patchy shadow in chest X-ray photos and atypical clinical symptoms should be treated with broad-spectrum antibiotics for at least two weeks,and SM and RFP should be avoided;sputum smear for acid-fast bacilli and sputum culture for mycobacteria should be done repeatedly.

Key words: Pneumonia, Pulmonary tuberculosis/diagnosis, Misdiagnosis