Nagao Genta, Okuzumi Shinichi, Kakimoto Tomoo, Minematsu Naoto
Department of Internal Medicine, Hino Municipal Hospital, Hino-shi, Tokyo, Japan.
IDCases. 2022 Mar 15;28:e01476. doi: 10.1016/j.idcr.2022.e01476. eCollection 2022.
(. ) was first reported in patients with pulmonary infection or lymphadenitis in 2009. To date, fewer than 20 cases of pulmonary or extra-pulmonary infections have been reported with the bacterium, and the clinical features remain unclear. We report a case of pulmonary infection in a 45-year-old man who had a history of cavitary pulmonary tuberculosis seven years ago. The patient visited a hospital due to hemosputum and a prolonged productive cough. Chest computed tomography revealed large and thick-walled cavities, with surrounding parenchymal infiltration in the right upper and lower lung lobes. The microbiological diagnosis of was based on positive culture results from multiple respiratory tract specimens. The patient's treatment started with antimycobacterial medicines, clarithromycin, moxifloxacin, and intravenous amikacin, in accordance with the drug susceptibility profile and previous case reports. The treatment stabilized the patient's symptoms and improved the thoracic imaging. In addition, the sputum culture was negative after the treatment. We reviewed the literature and summarized the clinical features of infection in 18 patients. All patients with extrapulmonary infections were immunocompromised. In contrast, pulmonary infection occurred in immunocompetent patients who often had a predisposing lung disease. Cavitary lesions were observed at diagnosis only in patients with prior cystic or cavitary lung disease, including pulmonary tuberculosis. This study contributes to the body of case knowledge of . infection and summarizes the clinical features in the literature.
（.）于2009年首次在肺部感染或淋巴结炎患者中被报道。迄今为止，该细菌引起的肺部或肺外感染报告病例少于20例，其临床特征仍不明确。我们报告一例45岁男性的肺部感染病例，该患者七年前有空洞型肺结核病史。患者因咯血痰和长期咳痰就诊。胸部计算机断层扫描显示右上和下肺叶有大的厚壁空洞，周围实质浸润。（.）的微生物学诊断基于多个呼吸道标本的阳性培养结果。根据药敏结果和既往病例报告，患者的治疗开始使用抗分枝杆菌药物、克拉霉素、莫西沙星和静脉注射阿米卡星。治疗使患者症状稳定，胸部影像学改善。此外，治疗后痰培养转阴。我们回顾了文献并总结了18例（.）感染患者的临床特征。所有肺外感染患者均免疫功能低下。相比之下，肺部感染发生在免疫功能正常且常有肺部易感疾病的患者中。仅在既往有囊性或空洞性肺部疾病（包括肺结核）的患者诊断时观察到空洞性病变。本研究丰富了（.）感染的病例知识体系并总结了文献中的临床特征。
