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结核还是非结核?分枝杆菌皮肤感染 1 例。

Tuberculosis or Nontuberculosis? A Case of Mycobacterial Skin Infection.

机构信息

Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey.

Department of Dermatology, Ege University Faculty of Medicine, İzmir, Turkey.

出版信息

Int J Mycobacteriol. 2024 Jul 1;13(3):351-353. doi: 10.4103/ijmy.ijmy_211_23. Epub 2024 Sep 14.

Abstract

Bacteria other than Mycobacterium tuberculosis and Mycobacterium leprae are known as nontuberculous mycobacteria (NTM), and the frequency of clinically symptomatic forms is increasing day by day. Mycobacterium fortuitum, a rapidly reproducing NTM, causes various clinical signs such as skin soft-tissue infection, surgical site infection, and disseminated infection in immunosuppressed patients. Although progress can be made in terms of diagnosis when growth is detected in culture, it is quite difficult to distinguish between infection and contamination. There is no place for antituberculosis treatment in the treatment of M. fortuitum. Antibiotics such as quinolones, trimethoprim-sulfamethoxazole, linezolid, doxycycline, clarithromycin, azithromycin, imipenem, tigecycline, linezolid, and amikacin are recommended at least in dual combination therapy. In this case presentation, the diagnosis and treatment of a 2-year skin soft-tissue infection with M. fortuitum growth in culture will be discussed.

摘要

除结核分枝杆菌和麻风分枝杆菌以外的细菌被称为非结核分枝杆菌(NTM),且其临床表现形式的频率日益增加。迅速繁殖的 NTM 分枝杆菌偶然分枝杆菌可引起各种临床症状,如免疫抑制患者的皮肤软组织感染、手术部位感染和播散性感染。虽然在培养物中检测到生长时可以在诊断方面取得进展,但区分感染和污染非常困难。分枝杆菌偶然分枝杆菌的治疗中没有抗结核治疗的位置。建议至少采用双联联合疗法使用喹诺酮类、复方磺胺甲噁唑、利奈唑胺、多西环素、克拉霉素、阿奇霉素、亚胺培南、替加环素、利奈唑胺和阿米卡星等抗生素。在本病例报告中,将讨论一例培养物中分枝杆菌偶然分枝杆菌生长的 2 年皮肤软组织感染的诊断和治疗。

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