Toda Satoko, Suematsu Rie, Inoue Hisako, Koarada Syuichi, Tada Yoshifumi, Aoki Yosuke, Nagasawa Kohei
Department of Rheumatology, Saga University Hospital.
Kansenshogaku Zasshi. 2010 May;84(3):300-4. doi: 10.11150/kansenshogakuzasshi.84.300.
A 67-year-old man clinically diagnosed a year earlier with sarcoidosis based on low-grade fever, lymphadenopathy, trunk skin rash, and histopathological skin tests was admitted for newly developing subcutaneous nodules on the trunk and arms and fever of 38 degrees C. Although initially suspected of recurrent sarcoidosis, he was diagnosed with Mycobacterium chromogenicum infection isolated from skin lesion culture. Combined clarithromycin of 800 mg/day, ethambutol of 750 mg/day, and embiomycin of 0.5 g/day was started, after which fever declined and WBC count and CRP decreased to normal in a week. One month later, skin lesions had disappeared. This case is interesting considering the association of nontuberculous mycobacterial infection with sarcoidosis.
一名67岁男性,一年前因低热、淋巴结病、躯干皮疹及组织病理学皮肤试验而临床诊断为结节病,现因躯干和手臂新出现皮下结节及38摄氏度发热入院。尽管最初怀疑为结节病复发,但从皮肤病变培养物中分离出产色分枝杆菌感染,从而确诊。开始联合使用每日800毫克克拉霉素、每日750毫克乙胺丁醇和每日0.5克卷曲霉素,一周后发热减退,白细胞计数和C反应蛋白降至正常。一个月后,皮肤病变消失。考虑到非结核分枝杆菌感染与结节病的关联,该病例很有意思。