Huang Hongchun, Deng Jingmin, Qin Caixia, Zhou Jianpeng, Duan Minchao
Department of Respiratory and Critical Care Medicine, Guangxi Autonomous Regional Jiangbin Hospital, Nanning, Guangxi, 530021, People's Republic of China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People's Republic of China.
Infect Drug Resist. 2021 Sep 7;14:3619-3625. doi: 10.2147/IDR.S316881. eCollection 2021.
is a rapidly growing non-tuberculous mycobacterium (NTM) with weak pathogenicity. Here, we present a rare case of disseminated and coinfection in a human immunodeficiency virus (HIV) negative patient.
A 28-year-old female was admitted to our hospital due to 2 months of swelling of lymph nodes on the right side of her cervix, accompanied by repeated low fever for more than 1 month. Biopsy of the right cervical lymph node and endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) both suggested granulomatous inflammation. The bacterial culture and mycobacteria examination of the lesion as well as HIV antibody test were all negative. Disseminated infection was diagnosed by the quantitative polymerase chain reaction (qPCR) results from the blood showing 1798 copies/ul. In the meantime, treatment with amphotericin B combined with cefoxitin was administered for suspected NTM infection. However, the once-dropped fever recurred and the lymph nodes continued to swell. Metagenomics next-generation sequencing (mNGS) detection of the lymph nodes indicated . After combination treatment with amphotericin B, voriconazole, linazolamide, and imipenem, the patient's body temperature returned to normal, the lymph node swelling was gradually reduced, and the lung lesion was absorbed.
We report the first case of an HIV-negative patient diagnosed with disseminated and coinfection with nonspecific clinical manifestation, in order to heighten awareness of these infections.
是一种致病性较弱、快速生长的非结核分枝杆菌（NTM）。在此，我们报告一例罕见的人类免疫缺陷病毒（HIV）阴性患者发生播散性感染及合并感染的病例。
一名28岁女性因右侧宫颈淋巴结肿大2个月，伴有反复低热1个多月入院。右侧颈部淋巴结活检及支气管内超声引导下经支气管细针穿刺活检（EBUS-TBNA）均提示肉芽肿性炎症。病变的细菌培养、分枝杆菌检查及HIV抗体检测均为阴性。血液定量聚合酶链反应（qPCR）结果显示每微升1798拷贝，据此诊断为播散性感染。同时，因怀疑NTM感染给予两性霉素B联合头孢西丁治疗。然而，体温一度下降后又复发，淋巴结持续肿大。对淋巴结进行宏基因组下一代测序（mNGS）检测提示……。在联合使用两性霉素B、伏立康唑、利奈唑胺和亚胺培南治疗后，患者体温恢复正常，淋巴结肿大逐渐减轻，肺部病变吸收。
我们报告了首例HIV阴性患者被诊断为播散性感染及合并感染，临床表现不具特异性，旨在提高对这些感染的认识。
