播散性脓肿分枝杆菌感染合并特发性CD4+ T淋巴细胞减少症：一例病例报告及文献复习
Disseminated Mycobacterium abscessus infection with idiopathic CD4+ T-lymphocytopenia: a case report and review of the literature.
作者信息
Wu Xianglin, Zhai Mingzhu, Xu Aohong, Zheng Yi
机构信息
Department of Laboratory Medicine, Guangming District People's Hospital, Shenzhen, 518106, China.
Center for Medical Experiments (CME), Guangming District People's Hospital, Shenzhen, 518106, China.
出版信息
J Med Case Rep. 2024 Dec 31;18(1):645. doi: 10.1186/s13256-024-05009-w.
BACKGROUND
Idiopathic CD4+ T lymphocytopenia is a rare immune dysfunction disease that is usually found after opportunistic infections. Mycobacterium abscessus is a rapidly growing mycobacterium that can cause pulmonary infections, lymphadenitis, skin and soft tissue infections, disseminated infections, among others, as a conditional pathogenic bacterium.
CASE PRESENTATION
We present the case of a 43-year-old Chinese woman who developed disseminated Mycobacterium abscessus infection due to idiopathic CD4+ T lymphocytopenia. The patient exhibited symptoms including skin infections, lymphadenitis, and bacteremia. A tailored multidrug therapy was initiated, guided by drug susceptibility testing. Within a month of treatment, the patient's fever resolved, and she exhibited a significant recovery and was discharged.
CONCLUSIONS
Cases of clinical idiopathic CD4+ T lymphocytopenia with Mycobacterium abscessus infection are not common. Clinicians should be vigilant and accurately identify Mycobacterium abscessus as an opportunistic pathogen when dealing with immunocompromised patients, in particular with idiopathic CD4+ T lymphocytopenia.
背景
特发性CD4 + T淋巴细胞减少症是一种罕见的免疫功能障碍疾病，通常在机会性感染后发现。脓肿分枝杆菌是一种快速生长的分枝杆菌，作为条件致病菌可引起肺部感染、淋巴结炎、皮肤和软组织感染、播散性感染等。
病例报告
我们报告一例43岁中国女性因特发性CD4 + T淋巴细胞减少症发生播散性脓肿分枝杆菌感染的病例。患者出现皮肤感染、淋巴结炎和菌血症等症状。在药敏试验指导下开始了针对性的多药治疗。治疗一个月内，患者发热消退，病情显著好转并出院。
结论
临床特发性CD4 + T淋巴细胞减少症合并脓肿分枝杆菌感染的病例并不常见。临床医生在处理免疫功能低下患者，特别是特发性CD4 + T淋巴细胞减少症患者时，应保持警惕并准确识别脓肿分枝杆菌为机会性病原体。
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