Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region.
Department of Microbiology, Li Ka Shing Faculty of Medicine, Pokfulam, University of Hong Kong, Hong Kong Special Administrative Region.
Int J Infect Dis. 2021 Feb;103:9-12. doi: 10.1016/j.ijid.2020.10.102. Epub 2020 Nov 4.
Our patient was a 4-year-old female with acute myeloid leukemia complicated with right calcaneal osteomyelitis due to Mycobacterium abscessus with subcutaneous abscesses extending to the popliteal and groin regions after two courses of induction chemotherapy according to NOPHO-AML 2012 protocol. She required multiple operations and prolonged anti-mycobacterial therapy. A high index of suspicion for mycobacterial infection is required for immunocompromised patients with prolonged fever or unusual presentation. Mycobacterial osteomyelitis is rare, difficult to diagnose and treat, and may necessitate prolonged interruption of anti-leukemic therapy. Multidisciplinary collaboration in patient management is crucial. Long-term toxicity of antimicrobials with uncertain efficacy should not be overlooked.
我们的患者是一名 4 岁女性，患有急性髓系白血病，在按照 NOPHO-AML 2012 方案进行了两个疗程的诱导化疗后，并发脓肿分枝杆菌引起的右侧跟骨骨髓炎，伴有皮下脓肿延伸至腘窝和腹股沟区域。她需要多次手术和长期抗分枝杆菌治疗。对于免疫功能低下、长期发热或表现异常的患者，需要高度怀疑分枝杆菌感染。分枝杆菌骨髓炎罕见，诊断和治疗困难，可能需要长时间中断白血病治疗。患者管理中的多学科合作至关重要。不应忽视具有不确定疗效的抗菌药物的长期毒性。
