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1例由胞内分枝杆菌引起的脊柱骨髓炎合并肺部鸟分枝杆菌复合群感染

[A case of spinal osteomyelitis due to Mycobacterium intracellulare with pulmonary Mycobacterium avium complex].

作者信息

Takakuwa Osamu, Oguri Tetsuya, Kasai Daishi, Nakamura Atsushi, Sato Shigeki, Ueda Ryuzo

机构信息

Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2010 Oct;48(10):759-64.

Abstract

A 76-year-old woman was admitted to our hospital in October 2007 because of fever and anorexia. Chest computed tomography demonstrated consolidation and reticular shadows in the right middle lobe and left lingula. Pulmonary nontuberculous mycobacteriosis was diagnosed based on isolation of Mycobacterium intracellulare from her sputum. Her symptoms, which included fever, were improved by chemotherapy with clarithromycin and ethambutol, but the treatment was halted due to adverse effects. Subsequently, she complained of lumbago from April 2008, and spinal osteomyelitis from the T-4 through T-5 vertebral bodies was suspected based on the findings of magnetic resonance imaging. Spinal osteomyelitis due to Mycobacterium intracellulare was diagnosed based on isolation of the bacteria from a tissue culture taken from the vertebral body. Surgery was performed after chemotherapy with clarithromycin, rifampicin and moxifloxacin. Spinal osteomyelitis caused by nontuberculous mycobacterium infection should be considered due to a worldwide increase in reported cases of pulmonary nontuberculous mycobacteriosis.

摘要

一名76岁女性于2007年10月因发热和厌食入住我院。胸部计算机断层扫描显示右中叶和左舌叶有实变和网状阴影。根据从她痰液中分离出胞内分枝杆菌,诊断为肺部非结核分枝杆菌病。她包括发热在内的症状通过克拉霉素和乙胺丁醇化疗得到改善,但因不良反应而停止治疗。随后,她自2008年4月起抱怨腰痛,基于磁共振成像结果怀疑T4至T5椎体发生脊髓炎。根据从椎体组织培养物中分离出细菌,诊断为由胞内分枝杆菌引起的脊髓炎。在使用克拉霉素、利福平和莫西沙星化疗后进行了手术。由于全球报道的肺部非结核分枝杆菌病病例增加,应考虑非结核分枝杆菌感染引起的脊髓炎。

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