Basu Pallavi, Williams Anwen, O'Brien Matthew T, Brouns Mattheus, Edwards Paul
Nevill Hall Hospital, Brecon Road, Abergavenny, NP7 7EG, UK.
Nevill Hall Hospital, Brecon Road, Abergavenny, NP7 7EG, UK.
Int J Infect Dis. 2016 Dec;53:12-14. doi: 10.1016/j.ijid.2016.10.006. Epub 2016 Oct 19.
A 44-year-old alcoholic (and therefore immunocompromised) hospital cleaner presented with general malaise, weight loss, and erythematous skin nodules. Computed tomography scanning revealed a neck mass invading the thyroid gland, pulmonary infiltrates, liver lesions, and deposits on the anterior abdominal wall, consistent with disseminated malignancy. However, tissue diagnosis showed a necro-inflammatory process with no evidence of malignancy. Microscopy and culture of samples failed to detect any infectious pathogen, but after an extended incubation period, Finegoldia magna was isolated. This case study illustrates the importance of tissue diagnosis in suspected disseminated malignancy and raises the risk of acquiring the rarer bacteria amongst hospital staff.
一名44岁的酗酒(因此免疫功能低下)医院清洁工出现全身不适、体重减轻和皮肤红斑结节。计算机断层扫描显示颈部肿块侵犯甲状腺、肺部浸润、肝脏病变以及前腹壁有沉积物,符合播散性恶性肿瘤表现。然而,组织诊断显示为坏死性炎症过程,无恶性肿瘤证据。样本的显微镜检查和培养未检测到任何感染病原体,但经过延长的孵育期后,分离出了巨大芬戈尔德菌。本病例研究说明了组织诊断在疑似播散性恶性肿瘤中的重要性,并提高了医院工作人员感染这种罕见细菌的风险。