Shimada Shinitiro, Iwai Kazuya
Department of Dermatology, Fujinomiya City General Hospital.
Kansenshogaku Zasshi. 2010 Mar;84(2):206-9.
An 64-year-old-woman with hypersensitivity pneumonia treated with combined of prednisolone and sulfamethoxazole and trimethoprim had a history of infectious pneumonia due to an unknown pathogen. About two weeks before she was first seen, she noticed right back swelling increasing rapidly in size and pain. Incision of the skin lesion produced a massive amount of pus and a pus smear showed acid-fast gram-positive branching filaments confirming diagnosis of nocardiosis. Symptoms decreased following open drainage and intravenous ceftriaxone and amikacin administration, but the woman died of urinary tract infection three months after diagnosis. Organisms isolated from pus were identified as Nocardia farcinica, thought to have infiltrated secondary from a pulmonary lesion to subcutaneous abcesses.
一名64岁患有过敏性肺炎的女性,接受泼尼松龙与磺胺甲恶唑及甲氧苄啶联合治疗,有因不明病原体导致的感染性肺炎病史。在她首次就诊前约两周,她注意到右背部肿胀,大小迅速增大且疼痛。皮肤病变处切开引出大量脓液,脓液涂片显示抗酸革兰氏阳性分支细丝,确诊为诺卡菌病。开放引流并静脉注射头孢曲松和阿米卡星后症状减轻,但该女性在诊断后三个月死于尿路感染。从脓液中分离出的病原体被鉴定为嗜皮诺卡菌,被认为是从肺部病变继发浸润至皮下脓肿。