Disseminated Mycobacterium Avium Complex Infection in a Non-HIV-infected Patient: A Case Report and Literature Review

非愛滋病引起之瀰漫性禽結核分枝桿菌感染：病例報告及文獻回顧

林祖燊(Chor-Shen Lim) ； 何肇基(Chao-Chi Ho) ； 余忠仁(Chong-Jen Yu)

《胸腔醫學》 25卷1期 (2010/02) Pp. 1-6

https://doi.org/10.29806/TM.201002.0001

摘要

瀰漫性禽結核分枝桿菌感染在非愛滋病患中是相當罕見的。既便是接受任何程度免疫抑制劑之非愛滋病病患，這樣的表現也相當罕見。近來許多研究顯示某些基因缺陷與非愛滋病患發生瀰漫性禽結核分枝桿菌感染有關。這些基因缺陷可以易感染一些胞內病原菌，像是沙門氏桿菌，或是以發生嚴重的低致病性分枝桿菌之感染來表現。我們在此報告一名78歲非愛滋病感染之男性，過去曾罹患堪薩斯分枝桿菌之肺部感染和沙門氏桿菌菌血症。病患最初以慢性阻塞性肺疾之急性發作表現，經一段時間的類固醇治療後發生瀰漫性禽結核分枝桿菌感染。病患最終死於多重器官衰竭。

關鍵字

瀰漫性禽結核分枝桿菌感染 ； 非愛滋病 ； 沙門氏桿菌菌血症 ； 類固醇

並列摘要

Disseminated Mycobacterium-avium complex infection (MAC) is rare in patients without acquired immunodeficiency syndrome (AIDS). Recent studies have shown that specific genetic defects have been associated with the development of disseminated nontuberculous mycobacteria infection in non-human immunodeficiency virus (HIV)-infected subjects. These genetic defects might present as susceptibility to intracellular pathogens, such as Salmonella species or severe infections due to otherwise poorly pathogenic mycobacteria. We herein report a 78-year-old non-HIV-infected man with history of pulmonary Mycobacterium kansasii and non-typhoidal Salmonella bacteremia, who presented with acute exacerbation of chronic obstructive pulmonary disease (COPD) and finally developed disseminated MAC infection after prolonged use of steroid. This patient subsequently died of multi-organ failure.

並列關鍵字

disseminated NTM infection ； non-HIV ； salmonellosis ； steroid