CAJ | 학술논문

目的提高对皮肤嗜血分枝杆菌感染的认识.方法报道2例皮肤嗜血分枝杆菌感染的临床表现、组织病理、病原学特点及治疗随访的情况.结果 2例患者均存在免疫功能低下,皮损均发生在外伤后,临床最初均表现为界限清楚的皮下结节,逐渐出现破溃结痂和脓肿形成.组织病理显示真皮内上皮细胞肉芽肿形成或组织细胞浸润,伴有灶状坏死和中性粒细胞脓肿形成.抗酸染色可见大量的阳性杆菌.细菌仅能在含有铁离子的培养基中生长,病原体经PCR后测序符合嗜血分枝杆菌.根据药敏结果,给予患者利福平、克拉霉素和莫西沙星联合治疗后3个月,病情好转.结论嗜血分枝杆菌感染常发生于免疫抑制人群中,继发于外伤,表现为皮下结节和脓肿,组织学符合感染性肉芽肿改变,分子生物学是鉴定本病的可靠方法.
목적 제고대피부기혈분지간균감염적인식.방법 보도2례피부기혈분지간균감염적림상표현、조직병리、병원학특점급치료수방적정황.결과 2례환자균존재면역공능저하,피손균발생재외상후,림상최초균표현위계한청초적피하결절,축점출현파궤결가화농종형성.조직병리현시진피내상피세포육아종형성혹조직세포침윤,반유조상배사화중성립세포농종형성.항산염색가견대량적양성간균.세균부능재함유철리자적배양기중생장,병원체경PCR후측서부합기혈분지간균.근거약민결과,급여환자리복평、극랍매소화막서사성연합치료후3개월,병정호전.결론 기혈분지간균감염상발생우면역억제인군중,계발우외상,표현위피하결절화농종,조직학부합감염성육아종개변,분자생물학시감정본병적가고방법.
Objective To improve the understanding of cutaneous Mycobacterium haemophilum infection.Methods Clinical and laboratory data were collected from two patients with cutaneous Mycobacterium haemophilum infection.The clinical and histopathologic manifestations, etiology and treatment of cutaneous Mycobacterium haemophilum infection were analyzed.Results The two patients were both immunocompromised.Lesions, which occurred after trauma in both the patients, began as well-marginated subcutaneous nodules, and then gradually progressed into ulceration with crusting and abscess formation.Histopathological examination revealed epithelial cell granuloma or histiocytic infiltrate in the dermis, as well as focal necrosis and neutrophil abscesses.Acid-fast staining showed abundant bacilli in tissues.These bacilli only grew in iron-containing medium, and were finally identified as Mycobacterium haemophilum by PCR and sequencing.According to the result of antimicrobial sensitivity testing, both the patients were treated with rifampicin, clarithromycin and moxifloxacin.Three months later, the condition was improved in both of them.Conclusions Mycobacterium haemophilum infection occurs most frequently in immunocompromised populations after trauma, manifests as subcutaneous nodules and abscesses with histopathological changes consistent with infectious granuloma.Molecular biological approaches are reliable for the identification of Mycobacterium haemophilum.