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一例由……引起的伴有心包炎的多发性浆膜炎病例

A Case of Polyserositis with Pericarditis Caused by .

作者信息

Figueiredo Filipa, Valido Teresa, Oliveira Jéssica, Chumbo Carolina, Paulo Joana Batista, Gomes Garcieth, Rocha Marta

机构信息

Department of Internal Medicine, Medicine III Prof. Doutor Fernando Fonseca Hospital, Amadora, Portugal.

出版信息

Eur J Case Rep Intern Med. 2025 Jun 24;12(7):005548. doi: 10.12890/2025_005548. eCollection 2025.

Abstract

UNLABELLED

The incidence of diseases and deaths caused by non-tuberculous mycobacteria (NTM) has been increasing globally. However, the broad and nonspecific clinical manifestations of NTM infections make diagnosis challenging, compounded by the difficulty in isolating NTM organisms. While NTM are rarely associated with heart disease, including pericarditis, and pleural effusion, such presentations are exceptional. We report the case of an 85-year-old female who presented with polyserositis, characterized by pleural and pericardial effusion, and was diagnosed with an unusual manifestation of NTM infection causing pericarditis. Initially, the patient was misdiagnosed with tuberculosis, which delayed the correct diagnosis and appropriate treatment. Upon accurate diagnosis, her condition improved with adjustments to the treatment regimen. This case highlights the importance of considering NTM infection in the differential diagnosis, particularly when faced with atypical presentations. Early recognition and timely microbiological testing are crucial for accurate diagnosis, enabling targeted treatment and improving patient outcomes.

LEARNING POINTS

Non-tuberculous mycobacteria infection can have non-specific presentations such as weight loss and night sweats, which are similar to lymphomas and tuberculosis.Unusual presentations of non-tuberculous mycobacteria infection, such as pleural effusions and pericarditis, can occur.Diagnosis is needed to ensure the correct treatment and may require polymerase chain reaction testing.

摘要

未标注

全球范围内,非结核分枝杆菌(NTM)引起的疾病和死亡发生率一直在上升。然而,NTM感染广泛且非特异性的临床表现使得诊断具有挑战性,加上分离NTM病原体存在困难。虽然NTM很少与包括心包炎和胸腔积液在内的心脏病相关,但这种表现很罕见。我们报告了一例85岁女性患者,其表现为多浆膜炎,以胸腔和心包积液为特征,被诊断为NTM感染导致心包炎的罕见表现。最初,该患者被误诊为结核病,这延误了正确诊断和适当治疗。准确诊断后,通过调整治疗方案,她的病情有所改善。该病例强调了在鉴别诊断中考虑NTM感染的重要性,特别是面对非典型表现时。早期识别和及时进行微生物检测对于准确诊断至关重要,能够实现针对性治疗并改善患者预后。

学习要点

非结核分枝杆菌感染可出现如体重减轻和盗汗等非特异性表现,类似于淋巴瘤和结核病。非结核分枝杆菌感染可出现如胸腔积液和心包炎等罕见表现。需要进行诊断以确保正确治疗,可能需要聚合酶链反应检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a30/12236685/b175f077bb1d/5548_Fig1.jpg

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