Tazawa Setsuko, Marumo Kenji, Higuchi Dousei, Yoshizawa Yasuo
Department of Central Laboratory Medicine, Showa University Fujigaoka Hospital, 1-30, Fujigaoka, Aoba-ku, Yokohama-shi, Kanagawa 227-8501 Japan.
Kekkaku. 2006 Oct;81(10):609-12.
A 49-year-old woman with a Mycobacterium fortuitum bloodstream infection, who has been managed with central venous (CV) catheterization for two years, was reported. She had undergone rectectomy for rectal cancer and gastectomy for stomach cancer at the ages of 36 and 42, respectively. Also, she had undergone adhesiotomy for four times for postoperative ileus at the ages between 44 and 47. She was admitted to our hospital because of fever (38.4 degrees C) with chill and fatigue, and a subcutaneous abscess at the right infraclavicular region located at the insertion site of the CV catheter (Hickman catheter). After the catheter was removed, the subcutaneous abscess was incised and a Penrose drain tube was inserted. M. fortuitum was detected after three days of blood culture and on the blood agar medium inoculated with purulent discharge from the drainage tube. After receiving these treatments, she was discharged from the hospital one month later. The isolates from these blood and purulent discharge specimens were identical on pulsed-field gel electrophoresis. Based on these findings, we concluded that the M. fortuitum bloodstream infection in this case might be caused by the organism in the subcutaneous abscess mediated by the CV catheter.
报告了一名49岁患有偶然分枝杆菌血流感染的女性，她接受中心静脉置管治疗已两年。她分别在36岁和42岁时因直肠癌接受了直肠切除术，因胃癌接受了胃切除术。此外，她在44岁至47岁之间因术后肠梗阻接受了4次粘连松解术。她因发热（38.4摄氏度）、寒战、乏力以及位于中心静脉导管（希克曼导管）插入部位的右锁骨下区域皮下脓肿而入住我院。导管拔除后，切开皮下脓肿并插入一根橡皮引流管。血培养3天后以及在接种了引流管脓性分泌物的血琼脂培养基上检测到偶然分枝杆菌。接受这些治疗后，她于1个月后出院。这些血液和脓性分泌物标本的分离株在脉冲场凝胶电泳上是相同的。基于这些发现，我们得出结论，该病例中的偶然分枝杆菌血流感染可能是由中心静脉导管介导的皮下脓肿中的病原体引起的。
