Yenrudi S, Shuangshoti S, Pupaibul K
Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 1991 Jan;74(1):47-54.
Two cases of nocardiosis with underlying SLE are presented. Both were female patients aged 19 and 34 years and had been treated with steroid and endoxan for some time. Death from lesions in the respiratory tract and right kidney with growth of Nocardia asteroides at autopsy was noted in the first case. The second patient exhibited fever with dyspnea and subsequent peripheral neuromuscular dysfunction. Disseminated nocardial abscesses in multiple organs including lungs, liver, spleen, lymph nodes and subcutaneous tissue were disclosed postmortem. Moreover, intravascular dissemination of the organisms had resulted in thrombosis of several blood vessels supplying the spinal cord resulting in widespread myelomalacia. Recent infarction of a few spinal nerve roots was also observed.
本文报告了两例合并潜在系统性红斑狼疮(SLE)的诺卡菌病病例。两名患者均为女性,年龄分别为19岁和34岁,均接受过一段时间的类固醇和环磷酰胺治疗。第一例患者因呼吸道和右肾病变,尸检时发现有星形诺卡菌生长,最终死亡。第二例患者表现为发热伴呼吸困难,随后出现周围神经肌肉功能障碍。死后尸检发现多个器官包括肺、肝、脾、淋巴结和皮下组织有播散性诺卡菌脓肿。此外,病原体的血管内播散导致了几条供应脊髓的血管血栓形成,造成广泛的脊髓软化。还观察到一些脊神经根近期发生梗死。