Department of Pathology and Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata 990-2292, Japan.
Hum Pathol. 2010 Nov;41(11):1646-9. doi: 10.1016/j.humpath.2010.02.017. Epub 2010 Jul 22.
Mycobacterium genavense (M genavense) has been recognized as a life-threatening pathogen in severely immunocompromised patients. To our knowledge, disseminated M genavense infection has never been described in immunocompetent individuals. Here, we report a case of disseminated M genavense infection in a healthy Japanese boy. A 15-year-old boy who had never been diagnosed with an immunodeficiency disorder was hospitalized because of ileus. Tumorous lesions were identified in the ileum, cecum, and ascending colon, resulting in stenosis of ileocecal valve. There was diffuse proliferation of histiocytes throughout the intestinal wall, along with lymphocytic infiltration. No nuclear or cellular atypia was present in these cells. Ziehl-Neelsen staining revealed numerous acid-fast bacteria in histiocytes. After surgery, systemic lymph node swelling was noticed by generalized examination, including the mesenteric and cervical lymph nodes. M genavense DNA was identified by direct sequencing of 16S ribosomal DNA that had been amplified by polymerase chain reaction.
分枝杆菌属(M genavense)已被认为是严重免疫功能低下患者的致命病原体。据我们所知,免疫功能正常的个体从未发生过播散性分枝杆菌属感染。在此,我们报告一例健康的日本男孩发生播散性分枝杆菌属感染。一名 15 岁的男孩从未被诊断患有免疫功能障碍,因肠梗阻住院。回肠、盲肠和升结肠均发现有肿瘤性病变,导致回盲瓣狭窄。整个肠壁的组织细胞弥漫性增生,伴有淋巴细胞浸润。这些细胞中没有核或细胞异型性。Ziehl-Neelsen 染色显示组织细胞中有大量抗酸杆菌。手术后,全身检查发现肠系膜和颈部淋巴结均有全身淋巴结肿大。通过聚合酶链反应扩增的 16S 核糖体 DNA 的直接测序鉴定出分枝杆菌属 DNA。