Zhang Lei, Liu Kai, Liu Lirong, Meng Chong, Chen Yongxing
Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China.
Ann Transl Med. 2022 Feb;10(3):155. doi: 10.21037/atm-22-105.
Nontuberculous mycobacteria (NTM) refer to a large group of mycobacteria other than complex and . () is a slow growing species of nontuberculous mycobacteria (NTM), which can cause infection in multiple organs, including the lungs. Using the technique of next-generation sequencing (NGS), we diagnosed disseminated infection in a patient with no obvious immunodeficiency. We report on a 66-year-old female patient who presented with enlarged cervical lymph nodes and an intermittent fever. Imaging showed multiple, enlarged, abnormal lymph nodes, a pulmonary mass and rib lesions that strongly suggested neoplasia. There was no significant improvement in symptoms after intermittent antibiotic treatment. The pathological results of multiple biopsies did not support the diagnosis of tumors. The diagnosis of infection was confirmed by NGS. The patient started standard treatment with clarithromycin, ethambutol, and moxifloxacin in July 2020. Since then and over the 10-month follow-up period, there has been a progressive reduction in the size of the enlarged lymph nodes and lung lesions, and no recurrence of fever or other symptoms. is a potential cause of infection (including of disseminated disease) even in patients with no obvious immunosuppression. The potential usefulness of the NGS of clinical samples should be highlighted.
非结核分枝杆菌（NTM）是指除结核分枝杆菌复合群和麻风分枝杆菌以外的一大类分枝杆菌。堪萨斯分枝杆菌是一种生长缓慢的非结核分枝杆菌（NTM），可导致包括肺部在内的多个器官感染。我们运用二代测序（NGS）技术，在一名无明显免疫缺陷的患者中诊断出播散性堪萨斯分枝杆菌感染。我们报告一例66岁女性患者，该患者表现为颈部淋巴结肿大和间歇性发热。影像学检查显示多个肿大的异常淋巴结、肺部肿块和肋骨病变，强烈提示为肿瘤。间歇性抗生素治疗后症状无明显改善。多次活检的病理结果不支持肿瘤诊断。通过NGS确诊为堪萨斯分枝杆菌感染。该患者于2020年7月开始使用克拉霉素、乙胺丁醇和莫西沙星进行标准治疗。自那时起，在10个月的随访期内，肿大淋巴结和肺部病变的大小逐渐缩小，未再出现发热或其他症状复发。即使在无明显免疫抑制的患者中，堪萨斯分枝杆菌也是感染（包括播散性疾病）的潜在病因。应强调临床样本NGS的潜在实用性。
