Disseminated Mycobacterium kansasii Infection in a Non-Human Immunosuppressive Virus-Infected Patient without Immunosuppressive Therapy

非愛滋病且無免疫抑制劑使用引起之瀰漫性堪薩斯分枝桿菌感染

王崇任(Chung-Jen Wang) ； 王秉槐(Ping-Huai Wang)

《胸腔醫學》 31卷3期 (2016/06) Pp. 169-175

摘要

在免疫功能低下患者，瀰漫性堪薩斯分枝桿菌有較高的死亡率，並且在非愛滋病患中是相當罕見的。我們在此報告一位非愛滋病且無免疫抑制劑使用之男性，過去曾有口腔癌及肺結核完治病史，經病理和細菌培養的證明，被診斷為瀰漫性堪薩斯分枝桿菌感染且影響致肺部及脊椎。結核分枝桿菌和堪薩斯分枝桿菌疾病的臨床表現有一些重疊，這在肺結核疾病流行國家中很難被診斷。該患者經完整抗生素治療完全恢復且追蹤至今仍然健康。早期診斷治療這類疾病除了需要臨床醫師高度的臨床經驗與微生物培養，積極切片檢查也是非常重要的。

關鍵字

堪薩斯分枝桿菌 ； 人類免疫缺陷病毒 ； 脊椎骨髓炎

並列摘要

Disseminated Mycobacterium kansasii (M. kansasii) infection has a high mortality rate in immunocompromised patients, but is rarely seen in non-human immunosuppressive virus (HIV)-infected patients. We report a patient with a history of oral cancer and pulmonary tuberculosis who was diagnosed as having disseminated M. kansasii infection with pulmonary and bone involvement, proven by pathology and culture. The clinical manifestations of Mycobacterium tuberculosis (MTB) and M. kansasii diseases have some overlap, making it difficult to make a correct diagnosis of M. kansasii in an MTB-endemic country. The patient recovered completely after antibiotic treatment, with no relapse up to the most recent followup. Early diagnosis requires a high index of clinical suspicion. Microbiologic studies and aggressive tissue proof are cornerstones of the diagnosis of disseminated M. kansasii infection.

並列關鍵字

Mycobacterium kansasii ； human immunodeficiency virus ； vertebral osteomyelitis