Ikeda Hiroshi, Nakamura Kiwamu, Ikenori Mei, Saito Takahiro, Nagamine Keisuke, Inoue Minoru, Sakagami Takuro, Suzuki Hiroko, Usui Mariko, Kanemitsu Keiji, Matsumoto Akinori, Shinbo Takuro
Department of Internal Medicine, Ohta-Nishinouchi Hospital, Japan.
Intern Med. 2016;55(20):3053-3058. doi: 10.2169/internalmedicine.55.6896. Epub 2016 Oct 15.
We herein report a case of disseminated Mycobacterium avium infection that involved both optic nerves, the conjunctiva, the right lower lung, and multiple skin lesions, including a thoracic nodule. The patient was a 65-year-old man without any significant medical history. The pathogen was detected in the patient's eye discharge, sputum, bronchial lavage fluid, and thoracic nodule. Anti-mycobacterial chemotherapy, including clarithromycin, rifampicin, and ethambutol, was administered, and the thoracic nodule was resected. An autoantibody to interferon-γ was detected in the patient's serum. Bilateral swelling of his optic nerves and facial dermatitis improved after initiating anti-mycobacterial chemotherapy.
我们在此报告一例播散性鸟分枝杆菌感染病例,累及双侧视神经、结膜、右下肺及多处皮肤病变,包括一个胸部结节。患者为一名65岁男性,无重大病史。在患者的眼分泌物、痰液、支气管灌洗液及胸部结节中检测到病原体。给予抗分枝杆菌化疗,包括克拉霉素、利福平及乙胺丁醇,并切除了胸部结节。在患者血清中检测到干扰素-γ自身抗体。开始抗分枝杆菌化疗后,其双侧视神经肿胀及面部皮炎有所改善。