Zammarchi E, Vichi G F, Falorni S, Bartolini P, Donati M A, Lenzi G
Pediatr Med Chir. 1987 Jan-Feb;9(1):57-61.
The authors describe a seven months and a half little girl, A.B., affected by multiple localization osteomyelitis caused by an Atypical Mycobacterium, with the culture identifies as M. Avium, belonging to the third group of Runjon classification. The radiographic tests show a primary pulmonary complex and some osteolytic areas of the seventh right rib and of the bones of the lower legs (femur and tibia). From the beginning a multiple antituberculous chemotherapy against non tuberculous mycobacterial disease has initiated: Streptomycin (for two months) associated with Rifampicin, Isoniazid and Pyridoxine. The patient responds very slowly to the treatment and only three years later the whole radiologic regression of the lesions occurs. The interest of the case comes from the extreme rarity of disseminated bone localization during an atypical mycobacterial infection, and also from the early beginning of the clinical and radiologic manifestations.
作者描述了一个七个半月大的小女孩A.B.,她患有由非典型分枝杆菌引起的多部位骨髓炎,培养结果鉴定为鸟分枝杆菌,属于Runjon分类的第三组。影像学检查显示原发性肺复合征以及右第七肋骨和小腿骨骼(股骨和胫骨)的一些溶骨区域。从一开始就启动了针对非结核分枝杆菌病的多种抗结核化疗:链霉素(使用两个月)联合利福平、异烟肼和吡哆醇。患者对治疗反应非常缓慢,直到三年后病变才完全在影像学上消退。该病例的有趣之处在于非典型分枝杆菌感染期间骨骼播散性定位极为罕见,以及临床和影像学表现出现得很早。