Department of Respiratory Medicine, Cellular Transplantation Biology, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan,
J Infect Chemother. 2013 Oct;19(5):964-8. doi: 10.1007/s10156-012-0539-8. Epub 2012 Dec 22.
We describe a 50-year-old woman with rapidly progressive pulmonary Mycobacterium abscessus (M. abscessus) infection accompanied by pleural effusion and organizing pneumonia (OP). CT scan showed consolidation, centrilobular shadows, ground-glass opacity (GGO), and cavities. A transbronchial lung biopsy showed nonnecrotizing granuloma surrounded by infiltrative lymphocyte-dominant inflammatory cells, and lymphocytes in bronchoalveolar lavage fluid (BALF) were increased. We considered OP occurred secondary to M. abscessus infection because clarithromycin, amikacin, and imipenem/cilastatin administration resulted in partial improvement. We added corticosteroids to the regimen, which resulted in a remarkable improvement. We report a case of pulmonary M. abscessus infection involving pleural effusion that responded favorably to medical therapy including corticosteroids.
我们描述了一位 50 岁女性，其患有快速进展性肺脓肿分枝杆菌（M. abscessus）感染，伴有胸腔积液和机化性肺炎（OP）。CT 扫描显示实变、小叶中心阴影、磨玻璃影（GGO）和空洞。经支气管肺活检显示，非坏死性肉芽肿被浸润性淋巴细胞占主导的炎症细胞包围，支气管肺泡灌洗液（BALF）中的淋巴细胞增多。我们考虑 OP 继发于 M. abscessus 感染，因为克拉霉素、阿米卡星和亚胺培南/西司他丁治疗导致部分改善。我们在方案中加入了皮质类固醇，结果显著改善。我们报告了一例伴有胸腔积液的肺脓肿分枝杆菌感染病例，该病例对包括皮质类固醇在内的药物治疗反应良好。
