Kos S, Důra J, Jirásek J
Department of Tuberculosis and Respiratory Diseases, Faculty Hospital, Plzen, Czechoslovakia.
Eur Respir J. 1989 Jan;2(1):96-7.
A 60 yr old previously healthy man was treated for gradually elevating fever and rash followed by leucopenia and mycosis of the gastrointestinal tract; he died within 6 weeks of the first symptoms appearing. Histologic examination revealed disseminated tuberculosis of paratracheal lymph nodes, liver, spleen and bone marrow with the presence of acid fast bacilli by smear examination. Multiple colonies of the same strain of Mycobacterium kansasii were isolated by bacteriological examination of lymph node and spleen tissue. Neither macroscopical nor histological examination showed any evidence of lung tuberculosis. The final diagnosis of the described acute disease and rapid death was stated as generalized extrapulmonary mycobacteriosis, which is a rare observation.
一名60岁既往健康的男性因发热逐渐升高、皮疹,随后出现白细胞减少和胃肠道霉菌感染而接受治疗;他在出现首发症状后的6周内死亡。组织学检查显示气管旁淋巴结、肝脏、脾脏和骨髓有播散性结核病,涂片检查发现抗酸杆菌。通过对淋巴结和脾脏组织进行细菌学检查,分离出了同一株堪萨斯分枝杆菌的多个菌落。肉眼和组织学检查均未显示任何肺结核的证据。所描述的急性疾病和快速死亡的最终诊断为全身性肺外分枝杆菌病,这是一种罕见的情况。