Hatakeyama Taku, Yokoo Keiki, Tatsuhige Ryota, Nagao Takayuki, Kikuchi Koki, Ota Satoshi, Yamada Gen, Chiba Hirofumi
Department of Respiratory Medicine Sapporo Hokushin Hospital Sapporo Japan.
Department of Respiratory Medicine Teine Keijinkai Hospital Sapporo Japan.
Respirol Case Rep. 2024 Dec 3;12(12):e70076. doi: 10.1002/rcr2.70076. eCollection 2024 Dec.
A 71-year-old man with silicosis was treated for infection. Antimycobacterial treatment for was terminated 1 year after a negative test result for the bacteria on sputum examination. One year following the treatment, the patient developed pneumonitis. In the sputum culture, growth of was not detected. Pneumonitis did not improve despite sufficient antibacterial therapy. Chest computed tomography scan revealed aggravated shadows of pneumonitis and swelling of supraclavicular lymph nodes. A lymph node biopsy was performed, and polymerase chain reaction testing revealed infection. We diagnosed the patient with pneumonitis and lymphadenitis due to recurrent infection. Antimycobacterial treatment with rifampicin, ethambutol, clarithromycin, and amikacin was initiated. Pneumonitis and the general status of the patient improved following the treatment. Lymphadenitis is rare in adults in the absence of any immunodeficiency condition. We speculate that silicosis is a risk factor for mycobacterial infection recurrence.
一名71岁的矽肺男性患者因感染接受治疗。在痰液检查细菌检测结果为阴性1年后,终止了抗分枝杆菌治疗。治疗1年后,患者出现肺炎。在痰培养中,未检测到[细菌名称未给出]生长。尽管进行了充分的抗菌治疗,肺炎仍未改善。胸部计算机断层扫描显示肺炎阴影加重,锁骨上淋巴结肿大。进行了淋巴结活检,聚合酶链反应检测显示[细菌名称未给出]感染。我们诊断该患者患有因复发性[细菌名称未给出]感染导致的肺炎和淋巴结炎。开始使用利福平、乙胺丁醇、克拉霉素和阿米卡星进行抗分枝杆菌治疗。治疗后,肺炎和患者的总体状况有所改善。在没有任何免疫缺陷状况的成年人中,淋巴结炎很少见。我们推测矽肺是分枝杆菌感染复发的一个危险因素。