Kobayashi A, Yoneda T, Tsukaguchi K, Yoshikawa M, Fu A, Tokuyama T, Okamoto Y, Okamura H, Nakaya M, Narita N, Shirayama R, Tomoda K, Nakajima H
Second Department of Internal Medicine, Nara Medical University, Japan.
Kekkaku. 1997 Jul;72(7):443-8.
The patient was 71-year-old male with a history of sinobronchial syndrome since 8 years ago. He has been suffering from cough, sputum and upper abdominal discomfort since January 1994. He was diagnosed as an early gastric cancer by endoscopy, and his chest X-ray film showed an infiltrative shadow in the right upper lung field. A smear of the sputum specimen was positive for acid fast bacilli, which were later identified as Mycobacterium intracellulare. In this case, before the Mycobacterium intracellulare infection, it was confirmed that his mucociliary transport was severely impaired by using aerosol inhalation cine-scintigraphy. This case suggests that an impairment of the local defence mechanisms may play an important role in the pathogenesis of Mycobacterium intracellulare infection.
该患者为71岁男性,8年前有鼻窦支气管综合征病史。自1994年1月起,他一直患有咳嗽、咳痰及上腹部不适。经内镜检查诊断为早期胃癌,胸部X线片显示右上肺野有浸润性阴影。痰标本涂片抗酸杆菌阳性,后鉴定为胞内分枝杆菌。在该病例中,在胞内分枝杆菌感染之前,通过气溶胶吸入电影闪烁显像证实其黏液纤毛运输严重受损。该病例提示,局部防御机制受损可能在胞内分枝杆菌感染的发病机制中起重要作用。