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[两例由嗜血性分枝杆菌引起的播散性皮肤非结核分枝杆菌病严重病例]

[Two severe cases of disseminated cutaneous nontuberculous mycobacteriosis due to Mycobacterium haemophilum].

作者信息

Nielsen Martin, Kreiter Carolin, Polsfuß Silke, Krause Andreas

机构信息

Abteilung Rheumatologie, Klinische Immunologie und Osteologie - Standort Wannsee, Immanuel Krankenhaus Berlin - Klinik für Innere Medizin, Berlin, Deutschland.

Abteilung Rheumatologie, Klinische Immunologie und Osteologie - Standort Buch, Immanuel Krankenhaus Berlin - Klinik für Innere Medizin, Berlin, Deutschland.

出版信息

Z Rheumatol. 2023 Mar;82(2):143-150. doi: 10.1007/s00393-021-01131-y. Epub 2021 Nov 26.

Abstract

Mycobacterium haemophilum is a rare pathogen belonging to the group of slowly growing nontuberculous mycobacteria (NTM) that can cause infections, especially in immunocompromised patients. Detection by culturing is difficult because M. haemophilum only grows under special cultivation conditions. Therefore, it is believed that the pathogen is too rarely identified as a cause of disease overall. In addition to patients with severe immunodeficiency, e.g. due to acquired immunodeficiency syndrome (AIDS), chemotherapy or immunosuppression after transplantation, patients with underlying rheumatic diseases are increasingly described in the literature, who are at risk due to the immunosuppressive treatment regimen. Clinically, ulcerative skin alterations, lymphadenopathy and arthropathy are in the foreground. In immunosuppressed patients with unclear skin lesions, infections due to M. haemophilum should be considered and specific microbiological diagnostics should be initiated.

摘要

嗜血性分枝杆菌是一种罕见的病原体,属于缓慢生长的非结核分枝杆菌(NTM),可引起感染,尤其是在免疫功能低下的患者中。由于嗜血性分枝杆菌仅在特殊培养条件下生长,通过培养检测很困难。因此,人们认为该病原体总体上很少被确定为疾病原因。除了严重免疫缺陷患者,如因获得性免疫缺陷综合征(AIDS)、化疗或移植后免疫抑制导致的患者外,文献中越来越多地描述了患有潜在风湿性疾病的患者,他们因免疫抑制治疗方案而处于风险中。临床上,溃疡性皮肤改变、淋巴结病和关节病最为突出。在皮肤病变不明的免疫抑制患者中,应考虑嗜血性分枝杆菌感染,并启动特定的微生物学诊断。

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