Komeno T, Itoh T, Ohtani K, Kamoshita M, Hasegawa Y, Hori M, Kobayashi T, Nagasawa T, Abe T
Division of Hematology, University of Tsukuba.
Intern Med. 1996 Apr;35(4):323-6. doi: 10.2169/internalmedicine.35.323.
A 38-year-old man with pancytopenia due to myelodysplastic syndrome exhibited persistent pyrexia and mediastinal lymphadenopathy. A biopsy specimen of the lymph nodes showed diffuse infiltration of epitheloid cells, including acid-fast bacilli identified as Mycobacterium kansasii. Cultures from gastric lavage and stool yielded M. kansasii, and granulomas were found in the bone marrow. A diagnosis of disseminated nontuberculous mycobacteriosis (DNTM) was established. The patient's condition improved after treatment with isoniazid, rifampicin, ethambutol and granulocyte colony-stimulating factor. Although DNTM due to M. kansasii is rare in Japan, it should be recognized as a possible cause of opportunistic infections.
一名因骨髓增生异常综合征导致全血细胞减少的38岁男性出现持续发热和纵隔淋巴结肿大。淋巴结活检标本显示上皮样细胞弥漫浸润，其中包括被鉴定为堪萨斯分枝杆菌的抗酸杆菌。胃灌洗和粪便培养均培养出堪萨斯分枝杆菌，且在骨髓中发现肉芽肿。确诊为播散性非结核分枝杆菌病（DNTM）。患者在接受异烟肼、利福平、乙胺丁醇和粒细胞集落刺激因子治疗后病情好转。尽管在日本，由堪萨斯分枝杆菌引起的DNTM很少见，但应将其视为机会性感染的一种可能病因。
