一例皮肤龟分枝杆菌感染需要对stephanolepidis分枝杆菌感染进行鉴别诊断

IF 1.1 Q4 ALLERGY

Journal of Cutaneous Immunology and Allergy Pub Date : 2022-09-08 DOI:10.1002/cia2.12276

Okuto Iwasawa MD, Koji Kamiya MD, PhD, Takayuki Suzuki MD, Shinya Watanabe PhD, Longzhu Cui MD, PhD, Daiki Karube MD, Soichiro Kado MD, Takeo Maekawa MD, PhD, Mayumi Komine MD, PhD, Mamitaro Ohtsuki MD, PhD

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引用次数: 1

摘要

一名87岁的日本男子被转诊到我们医院，他抱怨左前臂上的紫罗兰色斑块持续生长了一年多。患者的病史包括接触性皮炎（口服泼尼松治疗；7.5 mg/天）、慢性肾脏疾病、心肌梗死、糖尿病和人工血管置换术后的腹主动脉瘤。体格检查显示连续的紫红色斑块，伴有丘疹和结节（图1A，B）。组织病理学分析显示真皮中有中性粒细胞浸润的肉芽肿性病变（图1C，D），ZiehlNeelsen染色显示存在大量抗酸杆菌（图1E）。菌斑培养显示分枝杆菌生长迅速。使用MBT分枝杆菌文库v6.0（Bruker Daltonik）的Matrixassisted激光解吸电离超荧光质谱（MALDITOF MS）显示，分离物很可能是stephanolepidis分枝杆菌（得分值：1.85）（第二种可能性是chelonae分枝杆菌；得分值：1.83），口服克拉霉素是根据与stephanolepidis有密切关系的M.chelonae的标准治疗方案和抗菌药物敏感性测试结果开始的。由于患者的症状在治疗干预后得到改善，诱导治疗持续了6周。尽管以克拉霉素为基础的甲氧苄啶-甲恶唑或氯法齐明联合治疗暂时开始，但这些配套抗生素分别因药疹和QT延长而停止。继续单用克拉霉素治疗，导致斑块消失（图1F）；因此，这种治疗方法正在进行中。为了准确鉴定致病分枝杆菌，进行了全基因组测序（WGS）。WGS披露

本文章由计算机程序翻译，如有差异，请以英文原文为准。

A case of cutaneous Mycobacterium chelonae infection requiring a differential diagnosis of Mycobacterium stephanolepidis infection

查看原文本刊更多论文

A case of cutaneous Mycobacterium chelonae infection requiring a differential diagnosis of Mycobacterium stephanolepidis infection

Mycobacterium stephanolepidis is a rapidly growing mycobacterium, closely related to Mycobacterium chelonae. It was first reported in 2017, and whether it is infectious to humans is unknown. Here, we report a rare case of cutaneous M. chelonae infection requiring a differential diagnosis of M. stephanolepidis infection.

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来源期刊

Journal of Cutaneous Immunology and Allergy Medicine-Dermatology

CiteScore

0.60

自引率

10.00%

发文量

审稿时长

12 weeks