Choonhakarn C, Chetchotisakd P, Jirarattanapochai K, Mootsikapun P
Division of Dermatology, Faculty of Medicine, Srinagarind Hospital Medical School, Khon Kaen University, Thailand.
Br J Dermatol. 1998 Jul;139(1):107-10. doi: 10.1046/j.1365-2133.1998.02324.x.
We report the rare association of Sweet's syndrome with non-tuberculous mycobacteria in five patients (three women, two men, aged 25-41 years). Clinical and histological evidence supported the diagnosis of Sweet's syndrome in all patients. The skin lesions responded well to systemic corticosteroid but recurred in two cases. All of our patients had chronic disseminated non-tuberculous mycobacterial infection. They initially presented with lymphadenopathy and developed involvement in other organs later. All of them were treated as having tuberculous lymphadenitis based on pathological findings before definite diagnosis was made by culture. The organisms isolated were Mycobacterium chelonae in three cases, M. scrofulaceum in one case and M. avium intracellulare complex in one case. All the patients gradually improved with treatment but one had multiple recurrences. The search for an infectious agent, especially non-tuberculous mycobacteria, should be performed in cases of Sweet's syndrome that appear in association with chronic granulomatous lymphadenitis which is recalcitrant to antituberculous drugs.
我们报告了5例（3名女性，2名男性，年龄25 - 41岁）Sweet综合征与非结核分枝杆菌的罕见关联。临床和组织学证据支持所有患者的Sweet综合征诊断。皮肤病变对全身性皮质类固醇反应良好，但有2例复发。我们所有的患者都患有慢性播散性非结核分枝杆菌感染。他们最初表现为淋巴结病，后来其他器官也受到累及。在通过培养做出明确诊断之前，根据病理结果，他们都被当作结核性淋巴结炎进行治疗。分离出的病原体3例为龟分枝杆菌，1例为瘰疬分枝杆菌，1例为鸟分枝杆菌胞内复合群。所有患者经治疗后逐渐好转，但有1例多次复发。对于出现与对抗结核药物耐药的慢性肉芽肿性淋巴结炎相关的Sweet综合征病例，应寻找感染源，尤其是非结核分枝杆菌。
