Kitazawa Takatoshi, Yamamoto Ai, Nakayama Shin, Kawase Kyotaro, Wakabayashi Yoshitaka
Department of Medicine, Teikyo University, Japan.
Intern Med. 2025 Apr 15;64(8):1275-1279. doi: 10.2169/internalmedicine.4234-24. Epub 2024 Sep 4.
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.
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。
