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非结核分枝杆菌播散性感染的罕见病因

: A Rare Cause of Non-Tuberculous Mycobacteria Disseminated Infection.

作者信息

Nunes Ana Luisa, Coimbra Ana, Carvalho Ruben, Figueiredo Carolina, Almeida Vania, Lima Jandira, Santos Rui M

机构信息

Praceta Professor Mota Pinto, Coimbra 3004-561, Portugal.

Internal Medicine Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal.

出版信息

J Med Cases. 2022 Feb;13(2):61-65. doi: 10.14740/jmc3885. Epub 2022 Feb 16.

Abstract

(MS) is a rare and slow-growing type of non-tuberculous mycobacteria (NTM), with a human isolation prevalence of less than 0.2% of all NTM cases. MS may cause pulmonary infection, extra-pulmonary localized disease involving the skin, lymph nodes, bone, synovial tissue or kidneys and disseminated infection, when two or more organs are affected. When disseminated infection is present, the patients usually have an underlying immunosuppressive condition. The authors report the case of a 25-year-old patient with systemic lupus erythematosus, presenting with recurrent fever, non-productive coughing, weight loss and asthenia, as well as two violaceous plaques with superficial ulceration in the gluteal region. MS was isolated from the bronchial lavage and skin biopsy cultures, confirming the rare disseminated form of MS infection. After 10 months of follow-up on isoniazid, rifampin, ethambutol and pyrazinamide, no signs of relapse were evident. To date, only 16 other cases of MS disseminated disease have been reported.

摘要

马赛分枝杆菌(MS)是一种罕见且生长缓慢的非结核分枝杆菌(NTM),在所有NTM病例中其人体分离患病率低于0.2%。MS可引起肺部感染、累及皮肤、淋巴结、骨骼、滑膜组织或肾脏的肺外局限性疾病以及播散性感染(即两个或更多器官受到影响)。当出现播散性感染时,患者通常有潜在的免疫抑制状况。作者报告了一例25岁系统性红斑狼疮患者的病例,该患者表现为反复发热、干咳、体重减轻和乏力,以及臀部区域有两个伴有浅表溃疡的紫红色斑块。从支气管灌洗和皮肤活检培养物中分离出了MS,证实为罕见的MS感染播散形式。在使用异烟肼、利福平、乙胺丁醇和吡嗪酰胺进行10个月的随访后,未见复发迹象。迄今为止,仅报告了另外16例MS播散性疾病病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a4/8913006/cd85a8516cc6/jmc-13-061-g001.jpg

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