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鼻咽癌合并非结核分枝杆菌感染:一例报告及文献复习

Anti-Infection of Nasopharyngeal Carcinoma Combined with Non-Tuberculous Mycobacteria: A Case Report and Literature Review.

作者信息

Li Qinchuan, Guan Wenju, Zhang Jian, Chen Min, Zou Ya

机构信息

Department of Clinical Pharmacology, Chengdu Second People's Hospital, Chengdu, 610021, People's Republic of China.

Department of Oncology, Chengdu Second People's Hospital, Chengdu, 610021, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Aug 14;17:3527-3535. doi: 10.2147/IDR.S475377. eCollection 2024.

DOI:10.2147/IDR.S475377
PMID:39161469
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11330855/
Abstract

BACKGROUND

Patients with nasopharyngeal carcinoma (NPC) combined with non-tuberculous Mycobacteria-pulmonary disease (NTM-PD) are very rare in the clinic, and our case is the first patient with NPC combined with NTM-PD. For oncologists, rapid control of the symptoms of infection is essential to the treatment of the primary disease.

CASE PRESENTATION

A 58-year-old man who developed a NTM-PD after chemotherapy for nasopharyngeal carcinoma. Granulocytosis after chemotherapy is a major factor in the development of various infectious diseases. Nasopharyngeal tumor was found on MRI of the patient's head, and nasopharyngeal malignant tumor was considered after pathological examination after endoscopic resection of intranasal lesion, and then nasopharyngeal non-keratonic carcinoma (T4N1M0, stage IV) was confirmed in the department of oncology. The patient developed bone marrow suppression after chemotherapy and was admitted to hospital due to septic shock. Chest CT examination indicated pulmonary infection, and empirical antibiotic treatment was not effective. The NGS results showed that the patient was infected with Mycobacterium abscess. We treated with cefoxitin followed by moxifloxacin to reduce the lung lesions significantly.

CONCLUSION

NPC with NTM-PD is very rare, and the treatment of NTM-PD is very important for the prognosis of the patient's primary disease. Our study provides experience for anti-infection treatment of patients with immunosuppression.

摘要

背景

鼻咽癌(NPC)合并非结核分枝杆菌肺病(NTM-PD)的患者在临床上非常罕见,我们的病例是首例NPC合并NTM-PD的患者。对于肿瘤学家而言,快速控制感染症状对于原发性疾病的治疗至关重要。

病例介绍

一名58岁男性在鼻咽癌化疗后患上NTM-PD。化疗后的粒细胞增多是各种感染性疾病发生的主要因素。在患者头部的MRI检查中发现鼻咽部肿瘤,经鼻内病变内镜切除术后病理检查考虑为鼻咽部恶性肿瘤,随后在肿瘤科确诊为鼻咽非角化癌(T4N1M0,IV期)。患者化疗后出现骨髓抑制,并因感染性休克入院。胸部CT检查提示肺部感染,经验性抗生素治疗无效。二代测序(NGS)结果显示患者感染脓肿分枝杆菌。我们先用头孢西丁治疗,随后用莫西沙星治疗,肺部病变明显减轻。

结论

NPC合并NTM-PD非常罕见,NTM-PD的治疗对患者原发性疾病的预后非常重要。我们的研究为免疫抑制患者的抗感染治疗提供了经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/ab5ede6bc0c3/IDR-17-3527-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/7494f2cfde44/IDR-17-3527-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/db14279b73ba/IDR-17-3527-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/1466d091de0d/IDR-17-3527-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/ab5ede6bc0c3/IDR-17-3527-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/7494f2cfde44/IDR-17-3527-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/db14279b73ba/IDR-17-3527-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/1466d091de0d/IDR-17-3527-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b77/11330855/ab5ede6bc0c3/IDR-17-3527-g0004.jpg

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Primary healthcare professionals' perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study.基层医疗保健专业人员对肺癌预警症状和体征患者寻求帮助的看法:一项定性研究。
BMC Prim Care. 2022 May 18;23(1):119. doi: 10.1186/s12875-022-01730-x.
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Clinical, Imaging, Histological and Surgical Aspects Regarding Giant Paraovarian Cysts: A Systematic Review.
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Ther Clin Risk Manag. 2022 Apr 29;18:513-522. doi: 10.2147/TCRM.S361476. eCollection 2022.
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Consensus Recommendations for the Clinical Management of Hematological Malignancies in Patients with DNA Double Stranded Break Disorders.DNA双链断裂障碍患者血液系统恶性肿瘤临床管理的共识性建议
Cancers (Basel). 2022 Apr 14;14(8):2000. doi: 10.3390/cancers14082000.
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Nasopharyngeal carcinoma: A new synthesis of literature data (Review).鼻咽癌:文献数据的新综合(综述)
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