伊朗分枝杆菌菌血症与噬血细胞性淋巴组织细胞增生症：一例报告
Mycobacterium iranicum bacteremia and hemophagocytic lymphohistiocytosis: a case report.
作者信息
Grandjean Lapierre Simon, Toro Alexandre, Drancourt Michel
机构信息
Aix-Marseille Université, URMITE, UMR CNRS 7278, IRD 198, INSERM 1095, IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13005, Marseille, France.
Centre Hospitalier de Martigues, 13500, Martigues, France.
出版信息
BMC Res Notes. 2017 Aug 8;10(1):372. doi: 10.1186/s13104-017-2684-8.
BACKGROUND
Mycobacterium iranicum has recently been recognised as an opportunistic human pathogen. Although infectious conditions represent frequent triggers for hemophagocytic lymphohistiocytosis, non-tuberculous mycobacterial infections are rarely associated with this entity. To this date, M. iranicum infection has never been reported in France, has never been associated with hemophagocytic lymphohistiocytosis and has never been found to be multi-resistant on standardized antimicrobial susceptibility testing.
CASE PRESENTATION
We report a case of a French Caucasian man with secondary hemophagocytic lymphohistiocytosis in the context of M. iranicum bacteraemia and Hodgkin's disease. We review available data concerning M. iranicum antimycobacterial susceptibility testing and treatment outcomes. We also review the association between hemophagocytic lymphohistiocytosis and non-tuberculous mycobacterial infections.
CONCLUSION
Interpretation of M. iranicum positive cultures remains a clinical challenge and non-tuberculous mycobacterial infections need to be considered in secondary hemophagocytic lymphohistiocytosis differential diagnosis.
背景
伊朗分枝杆菌最近被确认为一种机会性人类病原体。尽管感染性疾病是噬血细胞性淋巴组织细胞增生症的常见触发因素，但非结核分枝杆菌感染很少与该病症相关。迄今为止，法国从未报告过伊朗分枝杆菌感染病例，该感染从未与噬血细胞性淋巴组织细胞增生症相关联，且在标准化抗菌药敏试验中从未发现其具有多重耐药性。
病例报告
我们报告了一例法国白种男性病例，该患者在患有伊朗分枝杆菌菌血症和霍奇金病的情况下出现继发性噬血细胞性淋巴组织细胞增生症。我们回顾了有关伊朗分枝杆菌抗菌药敏试验和治疗结果的现有数据。我们还回顾了噬血细胞性淋巴组织细胞增生症与非结核分枝杆菌感染之间的关联。
结论
对伊朗分枝杆菌阳性培养结果的解读仍然是一项临床挑战，在继发性噬血细胞性淋巴组织细胞增生症的鉴别诊断中需要考虑非结核分枝杆菌感染。
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