Koizumi Yusuke, Shimizu Kaoru, Shigeta Masayo, Minamiguchi Hitoshi, Hodohara Keiko, Andoh Akira, Tanaka Toshihide, Chikamatsu Kinuyo, Mitarai Satoshi, Mikamo Hiroshige
Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan.
Intern Med. 2016;55(22):3375-3381. doi: 10.2169/internalmedicine.55.6996. Epub 2016 Nov 15.
A 40-year-old man complaining of progressive body weight loss was diagnosed to have acquired immunodeficiency syndrome. Within 2 weeks after the initiation of combination antiretroviral therapy, he developed fever, massive cervical lymphadenopathy and a protruding subcutaneous abscess. A lymph node biopsy and abscess drainage revealed non-caseous granuloma and mycobacterium. The mycobacterium belonged to Runyon II group, but it showed no matches to any previously reported species. According to sequence analyses, the strain was identified as Mycobacterium shigaense. After six months of antimycobacterial treatment, the lesions were all successfully cured. This is the third case report of the novel mycobacterium, M. shigaense, presenting in associatioin with immune reconstitution syndrome.
一名40岁男性因渐进性体重减轻前来就诊,被诊断为获得性免疫缺陷综合征。在开始联合抗逆转录病毒治疗后的2周内,他出现发热、颈部大量淋巴结肿大和一个突出的皮下脓肿。淋巴结活检和脓肿引流显示为非干酪样肉芽肿和分枝杆菌。该分枝杆菌属于Runyon II组,但与之前报道的任何物种均不匹配。根据序列分析,该菌株被鉴定为滋贺分枝杆菌。经过6个月的抗分枝杆菌治疗,所有病变均成功治愈。这是第三例与免疫重建综合征相关的新型分枝杆菌——滋贺分枝杆菌的病例报告。