经支气管镜检查诊断以支气管内膜结核为表现的围产期结核病一例OA

A 3-month and 17-day-old male infant presented with a 4-week history of cough and was initially diagnosed with pneumonia.Despite over 20 days of antibiotic therapy(including ceftriaxone,piperacillin-tazobactam,and vancomycin),his symptoms did not improve.Chest CT revealed worsening pulmonary infiltrates.Bronchoscopic findings revealed stenosis of the left main bronchus with mucosal erosion,granuloma,and caseous necrosis.Rapid on-site evaluation of bronchoalveolar lavage fluid demonstrated positivity on acid-fast staining.Together with positive T-SPOT and high-throughput sequencing results for Mycobacterium tuberculosis,the infant was diagnosed with perinatal endobronchial tuberculosis.The infant was started on an HRZLzd anti-tuberculosis regimen(isoniazid 10 mg·kg-¹·d-1 intravenous infusion,rifampicin 12.5 mg·kg-¹·d-1 orally,pyrazinamide 30 mg·kg-¹·d-1 orally,and linezolid 10 mg·kg-¹·d-1 intravenous infusion).After one month of treatment,his clinical symptoms and pulmonary imaging findings markedly improved.