特发性CD4淋巴细胞减少伴播散性诺卡菌病：一例罕见病例及文献回顾。

IF 1.1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-29 DOI:10.2169/internalmedicine.4984-24

Nayuta Seto, Takayuki Suzuki, Takahiko Fukuchi, Momori Honjo, Shinya Watanabe, Longzhu Cui, Hitoshi Sugawara

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引用次数: 0

摘要

诺卡菌病通常影响免疫功能低下的患者；然而，特发性CD4淋巴细胞减少症（ICL）的临床特征仍然知之甚少。一名64岁的患者在播散性诺卡菌病后被诊断为ICL，包括菌血症、肺炎、膝关节关节炎和脑脓肿。患者接受甲氧苄啶-磺胺甲恶唑治疗，根据肾功能频繁调整剂量，住院5个月，每日2 - 12片单剂量。虽然他有一个1年的平稳的终身预防过程，他经历了长期的体力活动恢复。一篇文献综述强调了诺卡菌病在ICL中危及生命的性质，强调了及时诊断和量身定制的管理策略的重要性。

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Disseminated Nocardiosis in Idiopathic CD4 Lymphocytopenia: A Rare Case and Literature Review.

Nocardiosis typically affects immunocompromised patients; however, the clinical characteristics of idiopathic CD4 lymphocytopenia (ICL) remain poorly understood. A 64-year-old patient was diagnosed with ICL following disseminated nocardiosis, including bacteremia, pneumonia, knee arthritis, and brain abscess. The patient underwent trimethoprim-sulfamethoxazole therapy with frequent dose adjustments based on the renal function, ranging from 2 to 12 single-strength tablets daily over 5 months of hospitalization. While he had a 1-year uneventful course of lifelong prophylaxis, he experienced prolonged recovery in physical activity. A literature review highlighted the life-threatening nature of nocardiosis in ICL, underscoring the importance of a timely diagnosis and tailored management strategies.

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.