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多发性骨髓瘤治疗期间播散性非结核分枝杆菌感染:一例报告并文献复习

Disseminated Nontuberculous Mycobacterium Infection During Treatment of Multiple Myeloma: A Case Report and Review of the Literature.

作者信息

Kitazawa Takatoshi, Yamamoto Ai, Nakayama Shin, Kawase Kyotaro, Wakabayashi Yoshitaka

机构信息

Department of Medicine, Teikyo University, Japan.

出版信息

Intern Med. 2025 Apr 15;64(8):1275-1279. doi: 10.2169/internalmedicine.4234-24. Epub 2024 Sep 4.

Abstract

Multiple myeloma (MM) is a plasma B-cell malignancy characterized by immune dysfunction, with infection representing a major complication. Bacteria, including Streptococcus pneumoniae, are common pathogens in patients with MM, but reports on infections with nontuberculous mycobacteria (NTM) have been limited. We herein report a case of disseminated NTM infection in a patient with MM undergoing treatment with immunomodulatory drugs. At the diagnosis, the patient showed lymphocytopenia and was treated with clarithromycin, rifampicin, and ethambutol; however, culture positivity persisted, and the patient died. The possibility of NTM infection should be considered in cases of unexplained deterioration of the MM patient's general condition.

摘要

多发性骨髓瘤(MM)是一种以免疫功能障碍为特征的浆细胞B细胞恶性肿瘤,感染是主要并发症。包括肺炎链球菌在内的细菌是MM患者常见的病原体,但关于非结核分枝杆菌(NTM)感染的报道有限。我们在此报告1例接受免疫调节药物治疗的MM患者发生播散性NTM感染的病例。诊断时,患者出现淋巴细胞减少,并接受了克拉霉素、利福平和乙胺丁醇治疗;然而,培养结果持续呈阳性,患者死亡。MM患者出现无法解释的全身状况恶化时,应考虑NTM感染的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f5f/12097818/70420fa0b37e/1349-7235-64-1275-g001.jpg

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