Cong Jia, Wang Chenxi, Ma Li, Zhang Shaoya, Wang Jingwen
Department of Hematology, Beijing Tongren Hospital, Capital Medical University Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2017 May;96(18):e6800. doi: 10.1097/MD.0000000000006800.
Mycobacterium fortuitum (M.fortuitum) is one of the rapidly growing nontuberculous mycobacterium (NTM) that is widespread in the environment. M.fortuitum can cause different types of disease including pulmonary disease, lymphadenitis, cutaneous disease, and disseminated disease. However, the infection presenting as septicemia is exceedingly rare.
A 48-year-old immunocompromised male with extranodal NK/T-cell lymphoma, nasal type was admitted to the hospital because of high fever for 10 days.
The pathogen identified twice in the hemoculture was M.fortuitum, but not in the sputum culture. The chest computed tomographic (CT) scan showed a chronic inflammatory infection.
The patient was treated with sulfamethoxazole and levofloxacin.
The symptom of patient disappeared after the treatment for one week, and near-total absorption of the consolidation in CT after the treatment for one month. He continued the treatment for one year until the last negative hemoculture.
Although the M.fortuitum infection presenting as septicemia is rare, a high suspicion of M.fortuitum is required, particularly in the immunosuppressive patients. Timely and adequate treatment is necessary.
偶然分枝杆菌是环境中广泛存在的快速生长的非结核分枝杆菌之一。偶然分枝杆菌可引起不同类型的疾病，包括肺部疾病、淋巴结炎、皮肤疾病和播散性疾病。然而，以败血症形式出现的感染极为罕见。
一名48岁的免疫功能低下男性，患有鼻型结外NK/T细胞淋巴瘤，因持续高热10天入院。
血培养中两次鉴定出的病原体为偶然分枝杆菌，而痰培养中未检出。胸部计算机断层扫描（CT）显示为慢性炎症感染。
患者接受了磺胺甲恶唑和左氧氟沙星治疗。
治疗一周后患者症状消失，治疗一个月后CT显示实变几乎完全吸收。他持续治疗了一年，直到最后一次血培养结果为阴性。
尽管以败血症形式出现的偶然分枝杆菌感染很少见，但仍需高度怀疑，尤其是在免疫抑制患者中。及时且充分的治疗是必要的。
