Schubel K, Bassinet L, Monnet I, Jabot L, Atassi K, Honoré I, Maître B, Housset B, Mangiapan G
Service de pneumologie, hôpital intercommunal de Créteil, CHIC de Créteil, 40 avenue de Verdun, Créteil, France.
Rev Mal Respir. 2011 Mar;28(3):348-51. doi: 10.1016/j.rmr.2010.07.008. Epub 2011 Mar 2.
Mycobacterium chelonae (M. chelonae) is rarely responsible for respiratory infection. This report concerns the case of an 81-year-old man with previously asymptomatic bronchiectasis, colonised by M. chelonae for 3 years. He was hospitalised for acute dyspnoea and fever due to a right hydro-pneumothorax with cavitated alveolar opacities of the right lung. Pleural fluid and bronchial aspiration were positive for M. chelonae and no other microorganisms were detected. The effusion was drained and the patient treated with clarythromycin and amikacin. The radiological abnormalities improved but the patient's general condition remained poor. Treatment was continued for 11 months. Because of the absence of any other bacteria, clinical deterioration following broad-spectrum antibiotics and stabilisation of the lesions after anti-mycobacterial treatment, our diagnosis was severe M. chelonae pleuro-pneumonia in an immunocompetent patient.
龟分枝杆菌很少引起呼吸道感染。本报告涉及一名81岁男性,既往有无症状支气管扩张,被龟分枝杆菌定植3年。他因右侧液气胸伴右肺空洞性肺泡混浊导致急性呼吸困难和发热而住院。胸腔积液和支气管吸出物中龟分枝杆菌呈阳性,未检测到其他微生物。胸腔积液被引流,患者接受克拉霉素和阿米卡星治疗。放射学异常有所改善,但患者的一般状况仍然较差。治疗持续了11个月。由于未发现任何其他细菌,广谱抗生素治疗后临床病情恶化,抗分枝杆菌治疗后病变稳定,我们的诊断为免疫功能正常患者的严重龟分枝杆菌胸膜肺炎。