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莫西沙星和克拉霉素成功治疗免疫功能低下患者的皮肤龟分枝杆菌感染

Successful Treatment of Cutaneous Mycobacterium chelonae Infection in an Immunocompromised Patient Using Moxifloxacin and Clarithromycin.

作者信息

Miyahara Hanako, Yamada Enmi, Kiyohara Sawako, Taguchi Shijima, Kato Mikiro

机构信息

Department of Dermatology, Mito Kyodo General Hospital, University of Tsukuba, Mito, JPN.

Department of Infectious Diseases, University of Tsukuba Hospital, Tsukuba, JPN.

出版信息

Cureus. 2024 Dec 30;16(12):e76628. doi: 10.7759/cureus.76628. eCollection 2024 Dec.

Abstract

is a ubiquitous organism classified as a nontuberculous mycobacterium that rarely causes indolent skin or soft-tissue infections, especially in immunocompromised patients. Given the rarity of infection, diagnosis can be difficult because cutaneous lesions may be considered a worsening of the underlying disease or a benign condition. Here, we report a case of a rapidly progressing cutaneous infection in a patient with nephrotic syndrome. The cutaneous lesion was initially stable for five months, mimicking noninfectious etiologies; however, due to rapid worsening, prompt skin biopsy revealed infection. Clinicians should be aware of this unusual presentation of infection and have a low threshold for performing biopsies for the early diagnosis and prevention of disease progression. The patient was successfully treated using a combination of moxifloxacin and clarithromycin. The choices of antibiotics and duration of treatment for nontuberculous mycobacterial infections are not clearly determined and depend on the clinician's experience. As treatment duration is prolonged, it sometimes carries the risk of developing drug resistance. We also evaluated the efficacy of moxifloxacin and clarithromycin for treating cutaneous infections in immunocompromised patients who require long-term antibiotic therapy.

摘要

是一种普遍存在的微生物,被归类为非结核分枝杆菌,很少引起慢性皮肤或软组织感染,尤其是在免疫功能低下的患者中。鉴于感染罕见,诊断可能困难,因为皮肤病变可能被认为是基础疾病的恶化或良性状况。在此,我们报告一例肾病综合征患者快速进展的皮肤感染病例。皮肤病变最初稳定了五个月,类似非感染性病因;然而,由于迅速恶化,及时的皮肤活检显示为感染。临床医生应意识到这种感染的不寻常表现,并对进行活检以早期诊断和预防疾病进展保持较低阈值。该患者使用莫西沙星和克拉霉素联合治疗成功。非结核分枝杆菌感染的抗生素选择和治疗持续时间尚未明确确定,取决于临床医生的经验。随着治疗持续时间延长,有时会有产生耐药性的风险。我们还评估了莫西沙星和克拉霉素对需要长期抗生素治疗的免疫功能低下患者皮肤感染的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f036/11778020/c3f4cff46f17/cureus-0016-00000076628-i01.jpg

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