Miyashita Koichi, Matsuura Shun, Tajima Kenichi, Tajima Shogo, Aoki Ami, Sakagami Takuro, Koshimizu Naoki, Toyoshima Mikio, Suda Takafumi
Department of Respiratory Medicine, Fujieda City General Hospital, Japan.
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan.
Intern Med. 2018 Oct 15;57(20):3041-3045. doi: 10.2169/internalmedicine.0965-18. Epub 2018 May 18.
A 63-year-old woman presented with a fever, eruption, and sterile pyuria. A cystoscopic examination revealed submucosal nodular lesions in the trigone of the bladder, and a biopsy specimen showed epithelioid cell granulomas in the lamina propria of the bladder. Mycobacterium avium grew in the urine culture. Other organ involvement, such as the lungs, spleen, bones, muscles, and pelvic lymph nodes, was observed on radiological examinations, and M. avium was isolated from some organ lesions. Interferon-γ-neutralizing autoantibodies were detected in the patient's serum. Therefore, the patient was diagnosed with disseminated M. avium infection, which was resolved with antimycobacterial treatment.
一名63岁女性出现发热、皮疹和无菌性脓尿。膀胱镜检查发现膀胱三角区有黏膜下结节性病变，活检标本显示膀胱固有层有上皮样细胞肉芽肿。尿培养中分离出鸟分枝杆菌。影像学检查发现其他器官受累，如肺、脾、骨、肌肉和盆腔淋巴结，且在一些器官病变中分离出鸟分枝杆菌。患者血清中检测到干扰素-γ中和自身抗体。因此，该患者被诊断为播散性鸟分枝杆菌感染，经抗分枝杆菌治疗后病情得到缓解。
