Walter Chelsea, Acuña-Villaorduna Carlos, Hochberg Natasha S, Sinha Pranay
Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts.
Lemuel Shattuck Hospital, Department of Public Health, Boston, Massachusetts.
Am J Trop Med Hyg. 2022 Aug 15;107(3):595-9. doi: 10.4269/ajtmh.21-0839.
Mycobacterium tuberculosis (Mtb) is a complex pathogen causing multiple possible disease states in its host including latency, active disease, and elimination. While there is reasonable indirect evidence of elimination of tuberculosis (TB) in the absence of treatment, direct reports of autoregression are rare. We report a case of smear-negative, polymerase chain reaction (PCR)-positive TB disease regression in the absence of therapy due to severe adverse effects from antimycobacterial drugs. Indirect reports of TB autoregression, or self-cure, in the literature are reviewed, and an updated framework for conceptualizing Mtb infection is discussed.
结核分枝杆菌(Mtb)是一种复杂的病原体,可在其宿主中引发多种可能的疾病状态,包括潜伏、活动性疾病和清除。虽然有合理的间接证据表明在未经治疗的情况下结核病(TB)可被清除,但关于自愈的直接报道却很少。我们报告了一例因抗分枝杆菌药物严重不良反应而未经治疗的涂片阴性、聚合酶链反应(PCR)阳性的结核病病情消退病例。本文回顾了文献中关于结核病自愈的间接报道,并讨论了一个更新的结核分枝杆菌感染概念框架。