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免疫功能正常患者的马尔默分枝杆菌皮肤感染

[Mycobacterium malmoense cutaneous infection in an immunocompetent patient].

作者信息

Schmoor P, Descamps V, Lebrun-Vignes B, Crickx B, Grossin M, Nouhouayi A, Belaïch S

机构信息

Service de Dermatologie, HIA Bégin, Paris.

出版信息

Ann Dermatol Venereol. 2001 Feb;128(2):139-40.

Abstract

BACKGROUND

Mycobacterium malmoense is a mycobacterium rarely described as a human pathogen. We report the first case of cutaneous infection in an immunocompetent patient.

CASE REPORT

A 75-year-old woman presented with a cutaneous nodula on the back of her left hand. Histology of the node biopsy showed non caseating granuloma with giant and epithelioid cells. Acid-fast bacilli were isolated at direct smear and after culture. Mycobacterium malmoense was identified. The lesion has healed after surgery.

DISCUSSION

Mycobacterium malmoense is an environmental mycobacterium isolated from soil and water. Typically, most patients with Mycobacterium malmoense infections are old people with previously lung disease. A few cervical lymphadenitis in children and rare cases of tenosynovitis of the hand have been reported. Disseminated infections with cutaneous lesions have been exceptionally described in immunocompromised patients. Mycobacterium malmoense is slow growing and its identification is hard, sometimes requiring molecular analysis. Probably it's the reason why we present the first description of a cutaneous infection in an immunocompetent patient. This case indicates that Mycobacterium malmoense is also a cutaneous pathogen.

摘要

背景

马尔默分枝杆菌是一种很少被描述为人类病原体的分枝杆菌。我们报告了首例免疫功能正常患者的皮肤感染病例。

病例报告

一名75岁女性,左手背出现一个皮肤结节。结节活检的组织学检查显示为非干酪样肉芽肿,伴有巨细胞和上皮样细胞。直接涂片和培养后分离出抗酸杆菌。鉴定为马尔默分枝杆菌。手术后病变已愈合。

讨论

马尔默分枝杆菌是一种从土壤和水中分离出的环境分枝杆菌。通常,大多数马尔默分枝杆菌感染患者是患有既往肺部疾病的老年人。已报告了几例儿童颈部淋巴结炎和罕见的手部腱鞘炎病例。免疫功能低下患者中曾有过罕见的播散性感染伴皮肤病变的描述。马尔默分枝杆菌生长缓慢,其鉴定困难,有时需要进行分子分析。这可能就是我们首次描述免疫功能正常患者皮肤感染的原因。该病例表明马尔默分枝杆菌也是一种皮肤病原体。

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