一例由偶然分枝杆菌和脓肿分枝杆菌合并感染引起的胸腔积液。
A case of pleural effusion caused by Mycobacterium fortuitum and Mycobacterium mageritense coinfection.
机构信息
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
Department of Laboratory Medicine, Kobe City Nishi-Kobe Medical Center, 5-7-1 Kouji-dai, Nishi-ku, Kobe, Hyogo, 651-2273, Japan.
出版信息
BMC Infect Dis. 2019 Aug 15;19(1):720. doi: 10.1186/s12879-019-4366-8.
BACKGROUND
Non-tuberculous mycobacteria cause chronic pulmonary infection, but pleuritis and pleural effusion are rarely associated with infection with non-tuberculous mycobacteria, especially rapid-growing mycobacteria.
CASE PRESENTATION
A 68-year-old woman with rheumatoid arthritis who was using prednisone, azathioprine, and certolizumab pegol presented complaining of fever, dry cough, and night sweats for the past 2 weeks. Chest examination revealed bilateral opacity that was more pronounced on her right side. Bronchoalveolar lavage fluid and pleural effusion fluid were obtained, and revealed coinfection with Mycobacterium fortuitum and Mycobacterium mageritense. Imipenem/cilastatin, levofloxacin, and minocycline were prescribed for 6 months, and the patient was well and asymptomatic for the subsequent 6 months.
CONCLUSIONS
This is the first case report describing pleural effusion associated with coinfection with two different mycobacterial species. If the species cannot be identified, the possibility of mycobacterial coinfection should be considered.
背景
非结核分枝杆菌可引起慢性肺部感染，但分枝杆菌感染很少引起胸膜炎和胸腔积液，尤其是生长迅速的分枝杆菌。
病例介绍
一名 68 岁女性，类风湿关节炎患者，正在服用泼尼松、硫唑嘌呤和培塞利珠单抗，因发热、干咳和盗汗 2 周来就诊。胸部检查显示双侧混浊，右侧更明显。进行了支气管肺泡灌洗和胸腔积液检查，发现同时感染了脓肿分枝杆菌和偶发分枝杆菌。给予亚胺培南/西司他丁、左氧氟沙星和米诺环素治疗 6 个月，患者随后 6 个月病情良好，无症状。
结论
这是首例描述两种不同分枝杆菌种合并感染引起胸腔积液的病例报告。如果无法确定菌种，应考虑分枝杆菌合并感染的可能性。
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