Qin Jiayuan, Tang Guangmin
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
Heliyon. 2024 Apr 30;10(9):e30567. doi: 10.1016/j.heliyon.2024.e30567. eCollection 2024 May 15.
an infrequently reported non-tuberculous mycobacterium, is characterized by its slow-growing nature and capacity to simulate malignancies in clinical presentation. This report details a case of disseminated infection initially misidentified as cancer due to atypical symptoms, negative etiological tests, and imaging suggestive of a neoplastic disease However, comprehensive diagnostic investigations, including a bone marrow biopsy and flow cytometry analysis, excluded malignancy as the diagnosis. The patient subsequently developed palpable masses, from which a definitive diagnosis was made using metagenomic Next-Generation Sequencing (mNGS) and culture of aspirate. A regimen of clarithromycin, ethambutol, rifampin, and amikacin was administered, leading to substantial improvement and resumption of activities at the eight-month follow-up. This case highlights the diagnostic challenges posed by the nonspecific clinical presentation of disseminated infection and the importance of rigorous investigation to avoid grave misdiagnosis and treatment delays.
一种报告较少的非结核分枝杆菌，其特点是生长缓慢，在临床表现上有模拟恶性肿瘤的能力。本报告详细介绍了一例播散性感染病例，该病例最初因非典型症状、病因学检查阴性以及影像学提示肿瘤性疾病而被误诊为癌症。然而，包括骨髓活检和流式细胞术分析在内的综合诊断检查排除了恶性肿瘤的诊断。患者随后出现可触及的肿块，通过宏基因组下一代测序（mNGS）和抽吸物培养做出了明确诊断。给予克拉霉素、乙胺丁醇、利福平和阿米卡星治疗方案，在八个月的随访中病情有显著改善并恢复了活动。该病例突出了播散性感染非特异性临床表现带来的诊断挑战，以及进行严格检查以避免严重误诊和治疗延误的重要性。
