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在一位复发性肉芽肿伴多血管炎(韦格纳氏)患者中,分枝杆菌脓肿感染治疗后出现进行性呼吸困难,该患者还伴有听力损失,需要进行耳蜗植入。

Progressive dyspnoea following the treatment of Mycobacterium abscessus infection in an individual with relapsing granulamatosis with polyangitis (Wegener's), complicated by hearing loss requiring cochlear implantation.

机构信息

Internal Medicine & Nephrology Cypress Regional Hospital, Swift Current, Saskatchewan, Canada.

出版信息

BMC Pulm Med. 2012 Sep 4;12:47. doi: 10.1186/1471-2466-12-47.

Abstract

BACKGROUND

Granulomatosis with polyangitis (Wegener's) is a vasculitic disease predominantly affecting the lungs, skin, kidneys, ears, nose and throat. Mycobacterium abscessus is an uncommon rapidly growing mycobacterium causing sporadic lung disease. This is the first report of both GPA and Mycobacterium abscessus pulmonary disease reported in literature.

CASE PRESENTATION

We present a case report of a 33 year old Caucasian man with relapsing disease complicated by pulmonary infection with Mycobacterium abscessus. He subsequently required bilateral cochlear implantation for progressive sensori-neural hearing loss. His M. abscessus was treated successfully with a prolonged course of antimicrobial therapy. His Granulomatosis with polyangitis (Wegener's) relapsed towards the end of antimicrobial therapy and required treatment. Shortly after completing his antimicrobial therapy and relapse, he developed progressive dyspnea due to pulmonary fibrosis.

CONCLUSION

The potential causes of his progressive dyspnoea are discussed including the potential role of his underlying disease and treatment.

摘要

背景

肉芽肿性多血管炎(韦格纳氏)是一种血管炎疾病,主要影响肺部、皮肤、肾脏、耳朵、鼻子和喉咙。脓肿分枝杆菌是一种不常见的快速生长分枝杆菌,可引起散发性肺部疾病。这是文献中首次报道 GPA 和脓肿分枝杆菌肺部疾病。

病例介绍

我们报告了一例 33 岁的高加索男性病例,他患有复发性疾病,并发肺部脓肿分枝杆菌感染。随后,他因进行性感觉神经性听力损失需要进行双侧人工耳蜗植入。他的脓肿分枝杆菌通过长期的抗菌治疗成功治愈。他的肉芽肿性多血管炎(韦格纳氏)在抗菌治疗结束时复发,需要治疗。在完成抗菌治疗和复发后不久,他因肺纤维化出现进行性呼吸困难。

结论

讨论了导致他进行性呼吸困难的潜在原因,包括他潜在疾病和治疗的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f772/3517313/6d45d3433104/1471-2466-12-47-1.jpg

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