Zhao Joseph, Yap Ashton, Wu Eric, Yap Jane
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Fullerton Healthcare Corporate Limited, Singapore.
Respir Med Case Rep. 2020 Jan 26;29:101006. doi: 10.1016/j.rmcr.2020.101006. eCollection 2020.
We report a case of a patient with pulmonary melioidosis which radiologically mirrored a bronchogenic carcinoma with mediastinal lymphadenopathy. Such findings were observed in a Computed Tomography (CT) scan (Thorax) and Positron Emission Tomography (PET) scan (Body) in a previously healthy 57-year-old man with no significant medical risk factors for melioidosis other than his previous exposures to soil during outfield military training in Thailand, 37 and 28 years ago. He presented with acute symptoms of dry cough, pleuritic pain and fever. A CT Scan thorax revealed a left lower lobe mass with left pleural and pericardial effusion and mediastinal lymph nodes. Similarly, the PET scan showed various fluorodeoxyglucose (FDG)-positron uptake in these areas. However the lung mass biopsy cultured Burkholderia pseudomallei concurrently with a Melioidosis serology titre of >1:1024. He responded to intravenous Meropenem followed by Co-Trimoxazole and Doxycycline over the course of 21 weeks, ultimately leading to the resolution of any significant radiological findings.
我们报告一例肺类鼻疽病患者，其影像学表现类似伴有纵隔淋巴结肿大的支气管源性癌。在一名57岁既往健康男性的计算机断层扫描（CT）（胸部）和正电子发射断层扫描（PET）（全身）检查中观察到了此类表现，该患者除37年前和28年前在泰国野外军事训练期间接触过土壤外，没有其他明显的类鼻疽病医学风险因素。他出现了干咳、胸膜炎性疼痛和发热等急性症状。胸部CT扫描显示左肺下叶肿块，伴有左侧胸腔和心包积液以及纵隔淋巴结肿大。同样，PET扫描显示这些区域有不同程度的氟脱氧葡萄糖（FDG）正电子摄取。然而，肺肿块活检培养出了类鼻疽杆菌，同时类鼻疽病血清学滴度>1:1024。他在21周的疗程中接受了静脉注射美罗培南治疗，随后使用复方新诺明和多西环素，最终所有明显的影像学表现均消失。
