Tirapu J M, Alvarez M, Crespo J A, Rojo P, González-Igual J, Arriaga I, Cisterna R
Sección de Neumología, Santo Hospital Civil de Bilbao.
Med Clin (Barc). 1992 May 30;99(1):27-9.
A 19-years-old male was admitted for left bilobar pneumonia. All microbiologic studies in blood and in several samples obtained by bronchoscopy were negative. The patient worsened progressively despite antibiotherapy of a wide spectrum. A fine needle transparietal puncture was performed. The cultures of the sample were positive for Nocardia asteroides, a positive catalase germ. Immunologic studies initiated after this time showed negative tetrazolium nitroblue test, the results of which led to the diagnosis of chronic granulomatous disease. This disease is very infrequent and the polymorphonuclear leukocytes are genetically incapable of producing peroxides whose absence impedes lysis of the positive phagocytic catalase germs with which a histologic reaction is produced in the form of granulomas from which the name of the disease is derived.
一名19岁男性因左肺双叶肺炎入院。血液及经支气管镜获取的多个样本的所有微生物学检查均为阴性。尽管使用了广谱抗生素治疗，患者病情仍逐渐恶化。遂进行了经皮细针穿刺。样本培养结果显示星形诺卡菌阳性，这是一种过氧化氢酶阳性菌。此后开展的免疫学检查显示硝基蓝四氮唑试验阴性，该结果导致慢性肉芽肿病的诊断。这种疾病非常罕见，多形核白细胞在基因上无法产生过氧化物，而过氧化物的缺乏会阻碍对过氧化氢酶阳性吞噬菌的裂解，从而引发以肉芽肿形式出现的组织学反应，该病即由此得名。
