Clinical Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Department of Infectious Diseases, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Front Public Health. 2024 Sep 24;12:1387722. doi: 10.3389/fpubh.2024.1387722. eCollection 2024.
Herein, we report a case of lymphadenitis caused by . A 54-year-old woman with chronic myeloproliferative neoplasm was admitted to the hospital with cervical lymphadenopathy. After preliminary exclusion of various diseases such as lymphoma, Epstein-Barr virus infection, and autoimmune disease, a lymph node biopsy specimen showed epithelioid granulomatous lymphadenitis with caseous necrosis, epithelial-like cells, and multinucleated giant cells as seen in tuberculosis (TB). Although was never isolated, diagnostic anti-TB treatment was commenced. Following over 9 months of treatment, there was no significant reduction in the size of her cervical lymph nodes, and she continued to experience recurrent low-grade fevers. One sample from the fourth lymph node biopsy tested negative for metagenomic next-generation sequencing (mNGS), and another sample tested positive in the BACTEC MGIT960 liquid culture system, identifying the strains as . Anti-non-tuberculous mycobacteria (NTM) therapy was initiated, and the patient achieved symptom improvement. In conclusion, NTM lymphoid infection is easily misdiagnosed as long-term etiologic negativity.
在此，我们报告一例由 引起的淋巴结炎。一名 54 岁女性患有慢性骨髓增生性肿瘤，因颈部淋巴结病住院。在初步排除了淋巴瘤、EB 病毒感染和自身免疫性疾病等各种疾病后，淋巴结活检标本显示出类上皮肉芽肿性淋巴结炎，伴有干酪样坏死、上皮样细胞和多核巨细胞，类似于结核病（TB）。尽管从未分离出 ，但开始进行诊断性抗结核治疗。经过 9 个多月的治疗，她颈部淋巴结的大小没有明显缩小，并且她仍持续出现反复发作的低热。第四次淋巴结活检的一个样本经宏基因组下一代测序（mNGS）检测为阴性，另一个样本在 BACTEC MGIT960 液体培养系统中呈阳性，鉴定为 。开始抗非结核分枝杆菌（NTM）治疗后，患者症状得到改善。总之，NTM 淋巴感染很容易被误诊为长期病因学阴性。
