Lijia Zhi, Jia Chao Qi, Li Li, Shikun Deng, Peiyang Gao
Department of Intensive Care Unit, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
Front Med (Lausanne). 2024 Aug 6;11:1392430. doi: 10.3389/fmed.2024.1392430. eCollection 2024.
is rare to associated with human infection, which may cause abscesses in abdominal cavity, liver, breast, and spine. is very difficult to be cultivated in regular manner; detection of 16S rRNA sequence is the main evidence for infection. The clinical manifestations of infection resemble other agents of Nocardia, Tuberculosis and non-tuberculous Mycobacterium (NTM) due to their morphologic similarities. Hidradenitis suppurativa (HS) is a chronic inflammatory disorder, which affects the intertriginous skin and is associated with numerous systemic comorbidities. HS eventually leads to severe pain, multiple abscesses, pus discharge, and irreversible tissue destruction. has not been reported to cause HS and systemic comorbidities. We presented the case of a 33-year-old male with widespread soft tissue infection and multiple abscesses secondary to HS (Hurley stage III) inducing septic shock caused by in China. He was diagnosed as HS and treated with intravenous antibiotic empirically. He developed multiple abscesses including lung and scrota. Bacterial and fungal cultures on blood and secretions from multiple skin lesions were all negative. Due to the misdiagnosis and progression of disease, the patient was transferred to intensive care unit, and he underwent drainage of the chest and right hemothorax removal under thoracoscopic. During the hospitalization, the patient developed septic shock and received mechanical ventilation. Computerized tomography (CT) scans revealed mediastinal emphysema, multiple subcutaneous emphysema, and severe pneumonia. Gene analysis of samples of incision and drainage of pus at the skin showed the rare infection of . Finally, the patients with recurrent soft tissue infections and multiple abscesses with negative microbiological culture results recovered after effective abscess drainage and antibiotic therapy. We suggested that NGS is a crucial supplementary diagnostic tool in individuals with recurrent skin infections and multiple abscesses, especially when conventional diagnostic methods are inconclusive.
很少与人类感染相关，人类感染可能导致腹腔、肝脏、乳房和脊柱脓肿。很难以常规方式培养；16S rRNA序列检测是感染的主要证据。由于形态相似，感染的临床表现与诺卡菌、结核和非结核分枝杆菌（NTM）的其他病原体相似。化脓性汗腺炎（HS）是一种慢性炎症性疾病，影响皮肤褶皱处，与多种全身合并症相关。HS最终导致严重疼痛、多处脓肿、脓液排出和不可逆的组织破坏。尚未有报道称会导致HS和全身合并症。我们报告了一例33岁男性在中国因HS（Hurley III期）继发广泛软组织感染和多处脓肿导致感染性休克的病例。他被诊断为HS并经验性地接受静脉抗生素治疗。他出现了包括肺部和阴囊在内的多处脓肿。血液和多个皮肤病变分泌物的细菌和真菌培养均为阴性。由于误诊和疾病进展，患者被转入重症监护病房，并在胸腔镜下进行了胸腔引流和右血胸清除术。住院期间，患者发生感染性休克并接受了机械通气。计算机断层扫描（CT）显示纵隔气肿、多处皮下气肿和严重肺炎。皮肤脓肿切开引流样本的基因分析显示罕见的感染。最后，反复出现软组织感染和多处脓肿且微生物培养结果为阴性的患者在有效的脓肿引流和抗生素治疗后康复。我们建议，对于反复出现皮肤感染和多处脓肿的个体，尤其是当传统诊断方法无定论时，二代测序是一种关键的辅助诊断工具。
