Jastrzembski Stasia A, Teirstein Alvin S, Herman Steven D, DePalo Louis R, Lento Patrick A
Division of Pulmonary and Critical Care Medicine, Mount Sinai School of Medicine, Box 1232, One East 100th Street, New York, NY 10029, USA.
Mt Sinai J Med. 2002 Oct;69(5):350-3.
We report a patient with tissue-proven sarcoidosis receiving adrenocorticosteroid medication, who developed an enlarging mediastinal mass. Transcutaneous needle biopsy of the mass yielded pus which grew Nocardia asteroides on culture. Pleural effusion, bronchoesophageal fistula and brain nocardia metastases occurred. All evidence of active infection cleared with sulfa therapy. An enlarging mass in a patient with sarcoidosis unresponsive to corticosteroid therapy should provoke studies for other causes of mediastinal disease, including opportunistic infections.
我们报告了一名经组织学证实为结节病且正在接受肾上腺皮质类固醇药物治疗的患者，该患者出现了纵隔肿块增大的情况。对该肿块进行经皮穿刺活检，抽出的脓液在培养时培养出了星形诺卡菌。患者还出现了胸腔积液、支气管食管瘘和脑诺卡菌转移。经磺胺类药物治疗后，所有活动性感染的迹象均已消除。对于结节病患者，若其纵隔肿块在皮质类固醇治疗下仍持续增大，应考虑对纵隔疾病的其他病因进行检查，包括机会性感染。
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