Yan Jun, Zheng Rongrong, Zhang Zhongdong, Shi Jinchuan, Yan Tingbo, Liu Hong, Li Feng
The Second Infectious Disease Department, Xixi Hospital of Hangzhou, Hangzhou, 310023, People's Republic of China.
Radiology Department, Xixi Hospital of Hangzhou, Hangzhou, 310023, People's Republic of China.
Infect Drug Resist. 2024 Aug 9;17:3475-3482. doi: 10.2147/IDR.S473762. eCollection 2024.
(NTM) are a group of mycobacteria that are commonly found in the environment and can cause disease in humans. The symptoms of NTM infection can be similar to those of tuberculosis, making diagnosis challenging. The morbidity associated with NTM is increasing, and clinical management can be challenging.
This report details the case of a 32-year-old male who was found to have multiple enlarged and partially necrotic lymph nodes in the neck, axilla, mediastinum, and retroperitoneum. The causative agent was rapidly identified as through pathogen-targeted sequencing (tNGS). After two weeks of treatment with azithromycin, moxifloxacin, rifabutin, and amikacin, the patient's uncomfortable symptoms had resolved, and he is currently undergoing further review.
It is imperative that clinicians remain vigilant for the presence of NTM, particularly those that are rare, given their pervasiveness in the environment. Prompt diagnosis is of paramount importance, and molecular identification techniques represent a crucial tool in this regard. In vitro drug sensitivity testing should be conducted whenever feasible to guarantee the administration of an efficacious treatment regimen.
非结核分枝杆菌(NTM)是一组常见于环境中且可导致人类疾病的分枝杆菌。NTM感染的症状可能与结核病相似,这使得诊断具有挑战性。与NTM相关的发病率正在上升,临床管理也可能具有挑战性。
本报告详细介绍了一名32岁男性的病例,该患者被发现颈部、腋窝、纵隔和腹膜后有多个肿大且部分坏死的淋巴结。通过病原体靶向测序(tNGS)迅速确定了病原体。在用阿奇霉素、莫西沙星、利福布汀和阿米卡星治疗两周后,患者的不适症状已缓解,目前正在接受进一步检查。
鉴于NTM在环境中的普遍性,临床医生必须对其存在保持警惕,尤其是那些罕见的NTM。及时诊断至关重要,分子鉴定技术是这方面的关键工具。只要可行,就应进行体外药敏试验,以确保给予有效的治疗方案。