Alqurashi Moayad M, Alsaileek Ahmad, Aljizeeri Ahmad, Bamefleh Hana S, Alenazi Thamer H
Department of Medicine, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
IDCases. 2019 Aug 1;18:e00608. doi: 10.1016/j.idcr.2019.e00608. eCollection 2019.
Non-tuberculous mycobacterial species are uncommon human pathogens. They are divided into slow and rapid growing mycobacteria (RGM) with group as an uncommon pathogen among the RGM. A 19 years old male presented with a 1 month history of dyspnea, orthopnea, unintentional weight loss, palpitation, flu-like symptoms and dry cough. Physical examination revealed tachycardia, distended superficial chest veins with a decrease in breath sounds at the right lower lung with fine crepitations. CT of the chest showed a large anterior mediastinal mass infiltrating the pericardium and three chambers of the myocardium that was confirmed using echocardiography. Despite negative workup for tuberculosis, the patient was treated successfully using first-line anti-TB treatment, which was begun before the tissue culture grew To our knowledge, this is the first case in the literature of infection mimicking cardiomediastinal tuberculoma, and RGM should be suspected in similar presentations with negative TB workup, even in an immunocompetent patient. This is also the first patient to be treated using only first-line anti-tuberculous treatment successfully in the literature.
非结核分枝杆菌属是不常见的人类病原体。它们分为缓慢生长和快速生长的分枝杆菌（RGM），其中[具体菌群名称]作为RGM中一种不常见的病原体。一名19岁男性，有1个月的呼吸困难、端坐呼吸、非故意体重减轻、心悸、流感样症状和干咳病史。体格检查发现心动过速、浅表胸静脉扩张，右下肺呼吸音减弱并伴有细湿啰音。胸部CT显示前纵隔有一个大肿块，浸润心包和心肌的三个腔室，超声心动图证实了这一点。尽管结核病检查结果为阴性，但患者在组织培养结果出来之前就开始使用一线抗结核治疗并成功治愈。据我们所知，这是文献中首例类似心脏纵隔结核瘤的[具体菌群名称]感染病例，即使在免疫功能正常的患者中，对于结核病检查结果为阴性的类似表现也应怀疑RGM感染。这也是文献中首例仅使用一线抗结核治疗成功治愈的患者。
