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一名年轻免疫功能正常成年人的社区获得性冢村菌肺炎:一例被误诊为肺结核的病例及文献综述

Community-acquired Tsukamurella pneumonia in a young immunocompetent adult: a case misdiagnosed as pulmonary tuberculosis and literature review.

作者信息

Yang LiKun, Cao Yan, Dan Zijun, Wang Zhongyuan, Wang Xinjing

机构信息

a Institute of Tuberculosis , 309 Hospital, Beijing , China.

出版信息

Postgrad Med. 2017 Aug;129(6):563-566. doi: 10.1080/00325481.2017.1344513. Epub 2017 Jun 28.

Abstract

This report describes a case of Tsukamurella pneumonia in a 24-year-old immunocompetent woman. The patient was diagnosed as having pulmonary tuberculosis and was treated for nearly 9 months. The correct diagnosis was suspected only when the results of mycobacteria nucleic acid amplification tests on cultural colonies were negative. Tsukamurella was identified from the patient's sputum and bronchoalveolar lavage fluid by using 16S rRNA sequence analysis. Here, the clinical presentation, diagnosis, and treatment strategies of Tsukamurella pneumonia are discussed, along with a literature review. Tsukamurella pneumonia may be highly underdiagnosed owing to its similarity with pulmonary tuberculosis and the habitual thinking of doctors in countries with a high tuberculosis burden. Tsukamurella should be carefully considered in the etiology of tuberculosis-like lung diseases.

摘要

本报告描述了一例24岁免疫功能正常女性的冢村菌肺炎病例。该患者最初被诊断为肺结核并接受了近9个月的治疗。仅当培养菌落的分枝杆菌核酸扩增试验结果为阴性时,才怀疑诊断有误。通过16S rRNA序列分析,从患者痰液和支气管肺泡灌洗液中鉴定出了冢村菌。本文讨论了冢村菌肺炎的临床表现、诊断和治疗策略,并进行了文献综述。由于冢村菌肺炎与肺结核相似,且在结核病负担较高国家的医生存在习惯性思维,其可能存在大量漏诊情况。在类似结核的肺部疾病病因中,应仔细考虑冢村菌。

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