Drouineau Olivier, Rivault Odile, Le Roy Franck, Martin-Passos Elsa, Young Paul, Godin Michel
Service de néphrologie hémodialyse transplantation rénale, hôpital de Bois-Guillaume, CHU de Rouen, 147, avenue Maréchal-Juin, 76230 Bois-Guillaume, France.
Nephrol Ther. 2006 Jul;2(3):136-9. doi: 10.1016/j.nephro.2006.03.003. Epub 2006 May 19.
We report a case of a hemodialysed patient who developed a cutaneous Mycobacterium chelonae infection. This infection was only localised on the left upper limb, downstream from the arteriovenous fistula. M. chelonae is an unusual human pathogen, which is present in soil, dust, and stagnant water. Various factors, especially immunosuppression can favour this sort of infection in humans. Because of the ubiquity of the mycobacterium, the source of the inoculation sometimes remains unknown. However, a great number of cases are related to nosocomial infections. The preferential localizations are cutaneous, ocular, and pulmonary. Some cases of cutaneous infections due to M. chelonae, or caused by other atypical mycobacterium, are described in renal transplantation, peritoneal dialysis and hemodialysis. In the case we describe here, the source of contamination was not identified. The outcome was favourable with clarithromycin. This treatment is still continued because of a reappearance of the lesions when treatment was discontinued.
我们报告一例血液透析患者发生皮肤龟分枝杆菌感染的病例。该感染仅局限于动静脉瘘下游的左上肢。龟分枝杆菌是一种不常见的人类病原体,存在于土壤、灰尘和静水中。多种因素,尤其是免疫抑制,可促使人类发生这类感染。由于分枝杆菌无处不在,接种源有时仍不明确。然而,大量病例与医院感染有关。其好发部位为皮肤、眼部和肺部。在肾移植、腹膜透析和血液透析中,有一些由龟分枝杆菌或其他非典型分枝杆菌引起的皮肤感染病例报道。在我们描述的这个病例中,污染源未明确。使用克拉霉素治疗后预后良好。由于停药后病变复发,目前仍在继续治疗。