矽肺合并鸟分枝杆菌感染1例在完成初始治疗1年后复发并淋巴结炎。

IF 0.8 Q4 RESPIRATORY SYSTEM Respirology Case Reports Pub Date : 2024-12-03 eCollection Date: 2024-12-01 DOI:10.1002/rcr2.70076
Taku Hatakeyama, Keiki Yokoo, Ryota Tatsuhige, Takayuki Nagao, Koki Kikuchi, Satoshi Ota, Gen Yamada, Hirofumi Chiba
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引用次数: 0

摘要

一例71岁男性矽肺病患者因鸟分枝杆菌感染接受治疗。在痰液检查结果为阴性后1年终止对鸟分枝杆菌的抗菌治疗。治疗一年后,患者患上肺炎。痰培养中未见鸟分枝杆菌生长。尽管进行了充分的抗菌治疗,肺炎仍未得到改善。胸部电脑断层扫描显示肺炎阴影加重及锁骨上淋巴结肿大。行淋巴结活检,聚合酶链反应检测显示鸟分枝杆菌感染。我们诊断患者为肺炎及淋巴结炎,原因是复发性鸟分枝杆菌感染。开始使用利福平、乙胺丁醇、克拉霉素和阿米卡星进行抗细菌治疗。治疗后患者肺炎及一般情况好转。在没有任何免疫缺陷的情况下,淋巴结炎在成人中是罕见的。我们推测矽肺是分枝杆菌感染复发的危险因素。
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A case of silicosis with Mycobacterium avium infection relapsed with lymphadenitis 1 year after the completion of initial treatment.

A 71-year-old man with silicosis was treated for Mycobacterium avium infection. Antimycobacterial treatment for M. avium was terminated 1 year after a negative test result for the bacteria on sputum examination. One year following the treatment, the patient developed pneumonitis. In the sputum culture, growth of M. avium was not detected. Pneumonitis did not improve despite sufficient antibacterial therapy. Chest computed tomography scan revealed aggravated shadows of pneumonitis and swelling of supraclavicular lymph nodes. A lymph node biopsy was performed, and polymerase chain reaction testing revealed M. avium infection. We diagnosed the patient with pneumonitis and lymphadenitis due to recurrent M. avium infection. Antimycobacterial treatment with rifampicin, ethambutol, clarithromycin, and amikacin was initiated. Pneumonitis and the general status of the patient improved following the treatment. Lymphadenitis is rare in adults in the absence of any immunodeficiency condition. We speculate that silicosis is a risk factor for mycobacterial infection recurrence.

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来源期刊
Respirology Case Reports
Respirology Case Reports RESPIRATORY SYSTEM-
CiteScore
1.40
自引率
0.00%
发文量
178
审稿时长
8 weeks
期刊介绍: Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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