Department of Infectious Diseases, Kyoto City Hospital, Kyoto, Japan
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
J Infect Chemother. 2022 May;28(5):699-704. doi: 10.1016/j.jiac.2021.12.025. Epub 2022 Feb 21.
Mycobacterium tilburgii, a nonculturable mycobacterium, is an important nontuberculous mycobacterium that occasionally causes serious infections in patients with cellular immune deficiencies. Due to its nonculturable nature, information about its drug susceptibility is not available, and data about its clinical response to antimycobacterial treatment remains insufficient. Here, we report a case of a patient who presented with neck swelling and was finally diagnosed with cervical abscess caused by M. tilburgii carrying anti-interferon gamma autoantibodies using a molecular method. The relevant literature was reviewed in the context of epidemiological and clinical data on M. tilburgii infections. In this report, 15 patients were reported to be infected with M. tilburgii. Almost all patients had a cellular immune deficiency and presented with disseminated infections. Multiple refractory or relapse cases that often required prolonged antimycobacterial treatment have been reported, although a few fatal cases have also been reported. In conclusion, M. tilburgii is an important pathogen in patients with cellular immune deficiency. Physicians should thoroughly investigate cellular immune deficiency, including adult-onset immune deficiency with anti-interferon gamma autoantibodies, in patients with M. tilburgii infection.
耻垢分枝杆菌，一种不可培养的分枝杆菌，是一种重要的非结核分枝杆菌，偶尔会导致细胞免疫缺陷患者发生严重感染。由于其不可培养的特性，关于其药敏信息不可用，并且关于其对抗分枝杆菌治疗的临床反应的数据仍然不足。在这里，我们报告了一例患者，该患者出现颈部肿胀，最终使用分子方法诊断为携带抗干扰素γ自身抗体的耻垢分枝杆菌引起的颈脓肿。在报告中，15 名患者被感染耻垢分枝杆菌。几乎所有患者均存在细胞免疫缺陷，并呈现出播散性感染。据报道，经常需要长时间抗分枝杆菌治疗，存在许多难治性或复发性病例，尽管也有少数致命病例的报道。总之，耻垢分枝杆菌是细胞免疫缺陷患者的重要病原体。对于耻垢分枝杆菌感染的患者，医生应彻底调查细胞免疫缺陷，包括伴有抗干扰素γ自身抗体的成人发病免疫缺陷。
