Suzuki Kenichi, Terada Jiro, Sasaki Yuka, Kawasaki Takeshi, Naito Yusuke, Sakurai Takayuki, Tanabe Nobuhiro, Tatsumi Koichiro
Department of Respirology, Graduate School of Medicine, Chiba University, Japan.
Intern Med. 2014;53(12):1361-4. doi: 10.2169/internalmedicine.53.1931. Epub 2014 Jun 15.
A 74-year-old woman was referred to our hospital for an evaluation of unidentified pneumonia. She gradually developed a high-grade fever with a growing infiltrative shadow on chest CT and an enlarging bilateral cervical mass. She was diagnosed with a pulmonary Mycobacterium fortuitum (M. fortuitum) infection with cervical lymphadenitis based on the results of an open biopsy of the cervical lymph node. While the patient's clinical condition resolved almost completely after treatment with multiple antibiotics, neutralizing autoantibodies to interferon-gamma (IFN-γ) were identified in her serum. The progression of disseminated M. fortuitum infection in immunocompetent patients may be affected by the presence of autoantibodies to IFN-γ.
一名74岁女性因不明原因肺炎被转诊至我院。她逐渐出现高热,胸部CT显示浸润影增大,双侧颈部肿块也在增大。根据颈部淋巴结开放活检结果,她被诊断为肺部偶然分枝杆菌(偶然分枝杆菌)感染伴颈部淋巴结炎。虽然患者在接受多种抗生素治疗后临床症状几乎完全缓解,但在她的血清中发现了针对干扰素-γ(IFN-γ)的中和自身抗体。免疫功能正常患者中播散性偶然分枝杆菌感染的进展可能受IFN-γ自身抗体的影响。