CAJ | 학술논문

患者女,69岁,因右小腿红肿、结节、溃疡伴疼痛5个月,加重1个月就诊.皮肤科检查:右小腿轻度肿胀,右膝关节以下可见10余个大小不等明显高出皮面的暗红色结节、溃疡,渗出暗红色液体,质软,压痛明显.实验室检查:创面分泌物沙氏葡萄糖琼脂培养基培养出光滑、湿润、不产色白色菌落,抗酸染色示阳性杆菌.PCR扩增16S rRNA基因产物与龟分枝杆菌AB548610.1同源性达100％.皮损组织病理检查:皮下组织慢性化脓性炎症,抗酸染色示阳性杆菌,过碘酸雪夫染色阴性.诊断:龟分枝杆菌皮肤感染.经静脉滴注亚胺培南-西司他丁500 mg每日3次,口服复方磺胺甲(嗯)唑4片每日3次,治疗好转出院.
환자녀,69세,인우소퇴홍종、결절、궤양반동통5개월,가중1개월취진.피부과검사:우소퇴경도종창,우슬관절이하가견10여개대소불등명현고출피면적암홍색결절、궤양,삼출암홍색액체,질연,압통명현.실험실검사:창면분비물사씨포도당경지배양기배양출광활、습윤、불산색백색균락,항산염색시양성간균.PCR확증16S rRNA기인산물여구분지간균AB548610.1동원성체100％.피손조직병리검사:피하조직만성화농성염증,항산염색시양성간균,과전산설부염색음성.진단:구분지간균피부감염.경정맥적주아알배남-서사타정500 mg매일3차,구복복방광알갑(은)서4편매일3차,치료호전출원.
A 69-year-old female presented with erythematous swelling,tender nodules and ulcer in the right leg for five months,which had been aggravated for one month.Dermatological examination revealed a mild swelling of the right lower extremity,and more than ten dull red,elevated,tender and soft ulcerative nodules with bloody fluid exudates below the right knee.Culture of the bloody exudate on Sabouraud's dextrose agar grew smooth,wet and non-color-producing white colony,which was confirmed as an acid-fast bacillus.There was a 100％ homology in the sequence of 16S rRNA between the bacillus isolate and Mycobacterium chelonae type strain (Genebank accession number AB548610.1).Pathological study revealed a chronic purulent inflammation of subcutaneous tissue,which was positive for acid-fast staining,but negative for periodic acid-Schiff staining.A diagnosis of cutaneous Mycobacterium chelonae infection was made.The condition was improved and the patient was discharged after treatment with imipenem-cilastatin 500 mg thrice daily and compound sulphamethoxazole four tablets thrice daily.