Vreede R W, Kruyt J M, Nijhuis-Heddes J M A, Sastrowijoto S H
Vakgroep Medische Microbiologie, Reinier de Graaf Gasthuis, Reinier de Graafweg 3-11, 2625 AD Delft.
Ned Tijdschr Geneeskd. 2002 Mar 16;146(11):518-20.
An eleven-year-old girl was operated on due to right-sided chronic otitis media with effusion. After three months, an impressive enlargement of the mucosal lining developed, for which thorough debridement of the middle ear and mastoid was performed. Histological examination revealed a granulomatous inflammation, with negative Ziehl-Neelsen staining. Standard bacteriological cultures revealed no pathogenic micro-organisms. Three weeks later the same clinical picture developed, once again followed by extensive surgical debridement. After a thorough diagnostic work-up an atypical mycobacterium was found, namely Mycobacterium abscessus--formerly named M. chelonei subspecies abscessus. Following appropriate antibiotic therapy the patient was symptom-free. Mycobacterial infections should be part of the differential diagnosis of persistent otorrhoea.
一名11岁女孩因右侧慢性渗出性中耳炎接受手术。三个月后，黏膜显著增厚，为此对中耳和乳突进行了彻底清创。组织学检查显示为肉芽肿性炎症，萋-尼染色阴性。标准细菌培养未发现致病微生物。三周后，同样的临床表现再次出现，随后再次进行了广泛的手术清创。经过全面的诊断检查，发现了一种非典型分枝杆菌，即脓肿分枝杆菌——以前称为龟分枝杆菌脓肿亚种。经过适当的抗生素治疗，患者症状消失。分枝杆菌感染应作为持续性耳漏鉴别诊断的一部分。
