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患者 男,16岁。主因咳嗽、发热2个月就诊。2个月前因受凉后咳嗽、发热,体温38.5～40℃。在院外间断肌注或静脉滴注青霉素,每3天静脉推注地塞米松10mg治疗,地塞米松总量达200mg,遂出现口腔溃烂,吞咽困难,咳嗽加重伴气紧,于1996年4月2日入院。查体:体温39.2℃,慢性重病容,精神萎靡,营养差,全身皮肤粘膜未见黄染及出血点,体表淋巴结无异常肿大,口腔及咽喉部粘膜满布干酪样白斑,双肺呼吸音稍弱,无管样呼吸音及干湿啰音,心界不大,心律齐,心率102次/分,无病理性杂音,腹部平软,肝脾未扪及,神经系统未引出病理征。 实验室检查:血沉86mm/1h,口咽拭子和痰涂片找抗酸菌（++）,PPD5uH试验（-）,X线胸片示双肺弥漫性分布大小不等结节状阴影,边界不清,部分融合成片。纤支镜检查示口腔、
Male patient, 16 years old. The main cough, fever for 2 months treatment. 2 months ago due to cold cough, fever, body temperature 38.5 ~ 40 ℃. In the hospital intermittent intramuscular injection or intravenous penicillin, intravenous dexamethasone 10mg every 3 days of treatment, the total dexamethasone amounted to 200mg, then oral ulceration, dysphagia, cough aggravated with tight gas, in April 1996 Admission on the 2nd. Physical examination: body temperature 39.2 ℃, chronic severe disease, apathetic, poor nutrition, no yellow skin and mucous membrane bleeding and body surface lymph nodes no abnormal enlargement, mouth and throat mucosa covered with cheese-like white spots, lungs breathing Tone is weak, no tube-like breath sounds and wet and dry rales, heart is not big, heart rate Qi, heart rate 102 beats / min, no pathological murmur, abdominal soft, liver and spleen not palpable, the nervous system did not lead to pathological signs . Laboratory tests: Erythrocyte sedimentation rate 86 mm / 1 h, oropharyngeal swab and sputum smear look for acid-fast bacteria (++), PPD5uH test (-), X-ray showed diffuse distribution of diffuse lung nodules, The border is unclear and some are merged into pieces. Bronchoscopy showed oral cavity,