Thwaites Victoria, Colston Julia, Lomas-Cabeza Jose, Orosz Zsolt
Department of Obstetrics and Gynaecology, Stoke Mandeville Hospital, Aylesbury, UK.
Department of Infectious Disease, Churchill Hospital, Oxford, England, UK.
Int J Mycobacteriol. 2018 Jan-Mar;7(1):104-106. doi: 10.4103/ijmy.ijmy_166_17.
We report a case of an 88-year-old man with osteomyelitis of the right ankle, with histopathology demonstrating a Mycobacterium spindle cell pseudotumor. The Mycobacterium contained in this spindle cell pseudotumor was Mycobacterium chelonae. M. chelonae spindle cell pseudotumors are rare and have only been reported twice previously in the literature. Similarly, M. chelonae presenting as the pathogen in bone infection is rare. Due to this unusual presentation of M. chelonae, the antibiotic rationale was based largely on case reports and consisted of imipenem, clarithromycin, and linezolid. Antibiotic complications were experienced by the patient. Despite a renally adjusted dose of imipenem, the patient experienced imipenem toxicity and his antibiotics were modified to tigecycline and clarithromycin. Although his symptoms were clinically resolving, the patient sadly passed away before completing treatment.
我们报告一例88岁男性右踝关节骨髓炎病例，组织病理学显示为分枝杆菌梭形细胞假瘤。该梭形细胞假瘤中所含的分枝杆菌为龟分枝杆菌。龟分枝杆菌梭形细胞假瘤罕见，此前文献仅报道过两例。同样，龟分枝杆菌作为骨感染的病原体也很罕见。由于龟分枝杆菌的这种不寻常表现，抗生素治疗方案主要基于病例报告，包括亚胺培南、克拉霉素和利奈唑胺。患者出现了抗生素相关并发症。尽管亚胺培南进行了肾剂量调整，但患者仍出现亚胺培南毒性反应，其抗生素改为替加环素和克拉霉素。尽管患者症状在临床上有所缓解，但遗憾的是在完成治疗前去世。
