Nenoff P, Uhlemann R, Grünewald T, Nenning H, Grunewald S, Paasch U
Laboratorium für medizinische Mikrobiologie, Strasse des Friedens 8, 04579, Mölbis, Germany.
Hautarzt. 2007 Dec;58(12):1051-7. doi: 10.1007/s00105-007-1321-1.
Mycobacterium abscessus is the most pathogenic of the fast-growing mycobacteria, and it is resistant to most of the antimicrobial and tuberculostatic drugs available. This non-tuberculous mycobacterium is significant in medicine because it can contaminate post-traumatic wounds and be a causative agent in chronic skin and soft tissue infection after surgical procedures.A 60-year-old immunocompetent woman was suffering from chronic ulcers and abscesses on the heels and malleoli of both feet. Histological examination revealed a granulomatous inflammation with detection of acid-fast rods, albeit without fibrinoid necrosis. The repeated detection of atypical mycobacteria, which were ultimately identified as Mycobacterium abscessus, allowed the diagnosis of an atypical mycobacteriosis of the skin. This was successfully treated first with clarithromycin and rifabutin and later with a combination of ethambutol, minocycline, clofazimine and azithromycin.
脓肿分枝杆菌是快速生长分枝杆菌中致病性最强的，并且对大多数现有的抗菌和抗结核药物耐药。这种非结核分枝杆菌在医学上具有重要意义，因为它可污染创伤后伤口，并成为手术后慢性皮肤和软组织感染的病原体。一名60岁免疫功能正常的女性双足跟和踝关节处患有慢性溃疡和脓肿。组织学检查显示为肉芽肿性炎症，检测到抗酸杆菌，尽管没有纤维素样坏死。反复检测到非典型分枝杆菌，最终鉴定为脓肿分枝杆菌，从而诊断为皮肤非典型分枝杆菌病。最初用克拉霉素和利福布汀成功治疗，后来用乙胺丁醇、米诺环素、氯法齐明和阿奇霉素联合治疗。
