Sawahata Michiru, Hagiwara Eri, Ogura Takashi, Komatsu Shigeru, Sekine Akimasa, Tsuchiya Noriko, Takahashi Hiroshi
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.
Nihon Kokyuki Gakkai Zasshi. 2010 Nov;48(11):866-70.
A 24-year-old male never-smoker with no contributory medical history was referred to our division because of chronic productive cough and fever. His chest CT showed pulmonary consolidation including nodular shadows around the bronchovascular bundle in both upper lobes and right middle lobe. Sputum smears were negative but cultures were positive for Mycobacterium peregrinum, twice. He was given a diagnosis of pulmonary mycobacteriosis caused by M. peregrinum and treated with clarithromycin, levofloxacin, and ethambutol. His symptoms and the infiltrates improved, and further sputum cultures were negative for mycobacteria. M. peregrinum is a species included in the M. fortuitum group, of rapidly-growing non-tuberculous mycobacteria. To the best of our knowledge, only 2 cases with lung infection caused by M. peregrinum have been previously reported, both of which occurred in patients in their 60s with underlying diseases, including low immunity due to immunosuppressants for polymyositis, or bronchiectasia. We describe a rare case of pulmonary mycobacteriosis due to M. peregrinum in a healthy man without any underlying diseases.
一名24岁从不吸烟且无相关病史的男性因慢性咳痰和发热被转诊至我科。他的胸部CT显示肺部实变，包括双上叶和右中叶支气管血管束周围的结节状阴影。痰涂片阴性，但两次痰培养均检测到偶然分枝杆菌呈阳性。他被诊断为由偶然分枝杆菌引起的肺部分枝杆菌病，并接受了克拉霉素、左氧氟沙星和乙胺丁醇治疗。他的症状和肺部浸润有所改善，进一步的痰培养未检测到分枝杆菌。偶然分枝杆菌是迅速生长的非结核分枝杆菌中偶然分枝杆菌菌群的一个菌种。据我们所知，此前仅报道过2例由偶然分枝杆菌引起的肺部感染病例，这2例均发生在60多岁患有基础疾病的患者中，包括因治疗多发性肌炎使用免疫抑制剂导致的免疫力低下或支气管扩张。我们描述了一例健康男性无任何基础疾病却感染偶然分枝杆菌导致肺部分枝杆菌病的罕见病例。
