{"id":8898,"date":"2025-06-12T16:05:12","date_gmt":"2025-06-12T08:05:12","guid":{"rendered":"https:\/\/wp-cc.meddatas.com\/?p=8898"},"modified":"2025-09-16T13:50:24","modified_gmt":"2025-09-16T05:50:24","slug":"20241008-%e8%94%a1%e6%be%84%e9%be%99-a-67-year-old-man-with-interstitial-lung-disease-fever-and-myalgias-2","status":"publish","type":"post","link":"https:\/\/wp-cc.meddatas.com\/?p=8898","title":{"rendered":"\u3010Case Listen and Say\u30112023-N Engl J Med-A 67-Year-Old Man with Interstitial Lung Disease, Fever, and Myalgias"},"content":{"rendered":"<p style=\"text-align: center;\"><strong>\u6c47\u62a5\u4eba\uff1a\u8521\u6f84\u9f99\uff1b\u6c47\u62a5\u65f6\u95f4\uff1a2024.10.08<\/strong><\/p>\n<p><img loading=\"lazy\" class=\" wp-image-8899 aligncenter\" src=\"https:\/\/wp-cc.meddatas.com\/wp-content\/uploads\/2025\/06\/\u8521\u6f84\u9f99.jpg\" alt=\"\" width=\"754\" height=\"368\" srcset=\"https:\/\/wp-cc.meddatas.com\/wp-content\/uploads\/2025\/06\/\u8521\u6f84\u9f99.jpg 1694w, https:\/\/wp-cc.meddatas.com\/wp-content\/uploads\/2025\/06\/\u8521\u6f84\u9f99-300x146.jpg 300w, https:\/\/wp-cc.meddatas.com\/wp-content\/uploads\/2025\/06\/\u8521\u6f84\u9f99-1024x499.jpg 1024w, https:\/\/wp-cc.meddatas.com\/wp-content\/uploads\/2025\/06\/\u8521\u6f84\u9f99-768x374.jpg 768w, https:\/\/wp-cc.meddatas.com\/wp-content\/uploads\/2025\/06\/\u8521\u6f84\u9f99-1536x749.jpg 1536w\" sizes=\"(max-width: 754px) 100vw, 754px\" \/><\/p>\n<p style=\"text-align: center;\"><strong><b>Case 5-2023: A 67-Year-Old Man with Interstitial Lung Disease, Fever, and Myalgias<\/b><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><b>N Engl J Med 2023;388:642-50.\uff08<\/b><\/strong><strong><b>doi: 10.1056\/NEJMcpc2211364.\uff09<\/b><\/strong><\/p>\n<ul>\n<li><b><\/b><strong><b>\u4e3b\u8bc9\uff1a \u00a0<\/b><\/strong><\/li>\n<\/ul>\n<p>\u60a3\u8005\u4e3a67\u5c81\u7537\u6027\uff0c\u56e0\u201c\u53d1\u70ed\u3001\u808c\u75db\u3001\u6076\u5fc3\u5455\u5410\u201d\u5165\u9662\u3002<\/p>\n<ul>\n<li><b><\/b><strong><b>\u73b0\u75c5\u53f2\uff1a<\/b><\/strong><\/li>\n<\/ul>\n<p>9\u4e2a\u6708\u524d\u56e0\u54b3\u55fd\u3001\u547c\u5438\u56f0\u96be\u786e\u8bcaCOVID-19\u80ba\u708e\uff0c\u4e88\u745e\u5fb7\u897f\u97e6\u3001\u5730\u585e\u7c73\u677e\u53ca\u9ad8\u6d41\u91cf\u6c27\u7597\u540e\u597d\u8f6c\u51fa\u9662\uff0c\u4f46\u4ecd\u9700\u5bb6\u5ead\u6c27\u7597\uff084L\/min\uff09\u3002\u540e\u7eed\u54b3\u55fd\u53ca\u547c\u5438\u56f0\u96be\u52a0\u91cd\uff0c\u8bca\u65ad\u4e3a\u673a\u5316\u6027\u80ba\u708e\u5408\u5e76\u7ea4\u7ef4\u5316\u6027\u95f4\u8d28\u6027\u80ba\u75c5\uff0c\u4e88\u5421\u975e\u5c3c\u916e\u3001\u9709\u915a\u9178\u916f\u53ca\u6cfc\u5c3c\u677e\u6cbb\u7597\uff0c\u4f46\u75c7\u72b6\u672a\u7f13\u89e3\uff0c\u6700\u7ec8\u505c\u7528\u5421\u975e\u5c3c\u916e\u5e76\u9010\u6e10\u51cf\u505c\u6cfc\u5c3c\u677e\u3002\u5165\u9662\u524d2\u5929\u7a81\u53d1\u9ad8\u70ed\uff0840\u2103\uff09\u3001\u808c\u75db\u3001\u6076\u5fc3\u5455\u5410\uff0c\u4f34\u547c\u5438\u56f0\u96be\u52a0\u91cd\uff0c\u5bb6\u5ead\u6c27\u6d41\u91cf\u589e\u81f35L\/min\u3002SARS-CoV-2\u6297\u539f\u68c0\u6d4b\u9634\u6027\uff0c\u9042\u6025\u8bca\u5c31\u8bca\u3002<\/p>\n<ul>\n<li><b><\/b><strong><b>\u65e2\u5f80\u53ca\u4e2a\u4eba\u53f2\uff1a<\/b><\/strong><\/li>\n<\/ul>\n<p>\u80c3\u98df\u7ba1\u53cd\u6d41\u75c5\u3001\u963b\u585e\u6027\u7761\u7720\u547c\u5438\u6682\u505c\u30014\u5e74\u524d\u524d\u5217\u817a\u764c\u672f\u540e\u3002\u957f\u671f\u670d\u7528\u9709\u915a\u9178\u916f\u3001\u6cfc\u5c3c\u677e\u3001\u7532\u6c27\u82c4\u5576-\u78fa\u80fa\u7532\u5641\u5511\uff08PCP\u9884\u9632\uff09\u7b49\u836f\u7269\u3002\u5c45\u4f4f\u4e8e\u65b0\u82f1\u683c\u5170\u519c\u6751\uff0c\u6709\u868a\u866b\u53ee\u54ac\u53f2\uff0c\u8fd1\u671f\u66fe\u4fee\u526a\u8349\u576a\uff0c\u65e0\u5438\u70df\u53f2\u3002<\/p>\n<ul>\n<li><b><\/b><strong><b>\u67e5\u4f53\u53ca\u8f85\u52a9\u68c0\u67e5\uff1a<\/b><\/strong><\/li>\n<\/ul>\n<p>\u751f\u547d\u4f53\u5f81\uff1a\u4f53\u6e2936.6\u2103\uff0c\u6c27\u9971\u548c\u5ea697%\uff085L\/min\u6c27\u7597\uff09\uff0c\u547c\u5438\u6025\u4fc3\uff0828\u6b21\/\u5206\uff09\uff0c\u4f59\u6b63\u5e38\u3002<\/p>\n<p>\u5b9e\u9a8c\u5ba4\u68c0\u67e5\uff1a\u767d\u7ec6\u80de\u51cf\u5c11\uff083040\/\u03bcl\uff09\u3001\u6dcb\u5df4\u7ec6\u80de\u663e\u8457\u51cf\u5c11\uff08160\/\u03bcl\uff09\u3001\u8840\u5c0f\u677f\u51cf\u5c11\uff0859,000\/\u03bcl\uff09\uff0cALT\/AST\u5347\u9ad8\uff0876\/115 U\/L\uff09\uff0cCRP\u663e\u8457\u5347\u9ad8\uff08273.8 mg\/L\uff09\u3002<\/p>\n<p>\u80f8\u90e8CT\uff1a\u95f4\u8d28\u6027\u80ba\u708e\u8868\u73b0\uff08\u7f51\u683c\u5f71\u3001\u7275\u62c9\u6027\u652f\u6c14\u7ba1\u6269\u5f20\uff09\uff0c\u65b0\u589e\u53f3\u4fa7\u98df\u7ba1\u65c1\u6dcb\u5df4\u7ed3\u3002<\/p>\n<ul>\n<li><b><\/b><strong><b>\u9274\u522b\u8bca\u65ad\u601d\u8def \u00a0<\/b><\/strong><\/li>\n<\/ul>\n<ol>\n<li>\u611f\u67d3\u6027\u75be\u75c5\uff1a<\/li>\n<\/ol>\n<p>&#8211; 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