Saeki Sachiko, Matsuse Hiroto, Shimoda Terufumi, Soejima Yoshifumi, Ohno Hideaki, Kohno Shigeru
Department of Pulmonology, National Ureshino Hospital, Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Nihon Kokyuki Gakkai Zasshi. 2004 Jan;42(1):103-7.
A 65-year-old woman, treated with prednisolone (5 mg daily) for rheumatoid arthritis, visited our hospital because of right chest pain. Chest CT showed small nodular shadows in the right lung accompanied with right pleural effusion. A pulmonary Mycobacterium gordonae infection was diagnosed, since M. gordonae was identified twice from her sputum. She was treated with rifampicin, ethambutol and streptomycin for two months, and then streptomycin was replaced with clarithromycin. Three months after the initial treatment, M. gordonae was eradicated from her sputum. Pleural puncture revealed bloody, exudative, lymphocytotic pleural effusion, but no malignant cells were identified. Although pathological diagnosis by thoracoscopic pleural biopsy could not be performed, it is likely that the pleural effusion was associated with the pulmonary M. gordonae infection in the present case.
一名65岁女性,因类风湿关节炎接受泼尼松龙治疗(每日5毫克),因右侧胸痛前来我院就诊。胸部CT显示右肺有小结节影,并伴有右侧胸腔积液。由于从她的痰液中两次鉴定出戈登分枝杆菌,因此诊断为肺部戈登分枝杆菌感染。她接受了利福平、乙胺丁醇和链霉素治疗两个月,然后链霉素被克拉霉素替代。初始治疗三个月后,痰液中的戈登分枝杆菌被清除。胸腔穿刺显示血性、渗出性、淋巴细胞性胸腔积液,但未发现恶性细胞。虽然无法通过胸腔镜胸膜活检进行病理诊断,但在本病例中,胸腔积液很可能与肺部戈登分枝杆菌感染有关。