非结核分枝杆菌感染合并胸膜炎的临床分析

[Clinical analysis of nontuberculous mycobacterial infection complicated by pleurisy].

作者信息

Sado Toshikatsu, Nakamura Yasukiyo, Kita Hideo

出版信息

Kekkaku. 2014 Dec;89(12):821-4.

Abstract

OBJECTIVE

There are few reports describing pleurisy caused by nontuberculous pulmonary mycobacteriosis; in addition, there are few reports describing the frequency of cases.

METHOD

We retrospectively studied 116 consecutive cases of nontuberculous mycobacteriosis occurring between January 2009 and January 2014.

RESULT

Of these, 7 patients (6.0%) were diagnosed with pleuritis caused by nontuberculous pulmonary mycobacteriosis. One patient each had a history of ulcerative colitis, rheumatoid arthritis treated with steroids, and retinitis pigmentosa. Pleural effusion was examined in all 7 cases. In addition, nontuberculous mycobacteria were cultured from pleural effusion in 4 of the 7 cases; all were cases of Mycobacterium avium complex infection. The mean adenosine deaminase level in pleural effusion was 86 U/mL, and in 5 out of 7 cases, the adenosine deaminase level was greater than 50 U/mL. Pneumothorax occurred with pleuritis in 5 cases. Pleuritis was treated with NTM therapy in 5 cases, and pleural effusion decreased or cleared completely in all cases.

CONCLUSION

To reveal pleurisy accompanied by nontuberculous mycobacteriosis, further consideration is needed.

摘要

目的

描述非结核性肺部分枝杆菌病所致胸膜炎的报告较少；此外，描述病例发生频率的报告也较少。

方法

我们回顾性研究了2009年1月至2014年1月期间连续发生的116例非结核性分枝杆菌病病例。

结果

其中，7例（6.0%）被诊断为非结核性肺部分枝杆菌病所致胸膜炎。1例患者有溃疡性结肠炎病史，1例有接受类固醇治疗的类风湿关节炎病史，1例有视网膜色素变性病史。对所有7例患者的胸腔积液进行了检查。此外，7例中有4例胸腔积液培养出非结核分枝杆菌；均为鸟分枝杆菌复合群感染病例。胸腔积液中腺苷脱氨酶平均水平为86 U/mL，7例中有5例腺苷脱氨酶水平大于50 U/mL。5例胸膜炎患者发生气胸。5例胸膜炎患者接受非结核分枝杆菌治疗，所有病例胸腔积液均减少或完全消退。