Mycobacterium Avium Complex引起之皮膚類孢子絲菌病：病例報告

Sporotrichosis-Like Dermatosis Caused by Mycobacterium Avium Complex: A Case Report

陳冠宇(Guan-Yu Chen) ； 顏經洲(Jing-Jou Yan) ； 曾興隆(Heng-Leong Chan) ； 許漢銘(Hamm-Ming Sheu)

《中華皮膚科醫學雜誌》 22卷1期 (2004/03) Pp. 46-52

https://doi.org/10.29784/DS.200403.0005

摘要

在本文中，我們報告一例三十歲女性在其右大腿及膝蓋出現類似孢子絲菌病樣分佈的三個會痛且變大的皮下結節及潰瘍。組織病理學可見不規則表皮增生且有緻密的發炎細胞及多核巨大細胞浸潤。使用特殊染色並無陽性變化。故將此病患視為孢子絲菌病的情形下，開始給予口服potassium iodide 3 g/ day的治療，一個月後並無改善。因此懷疑是否為非典型結核菌感染，經由連鎖聚合酶反應，顯示為Mycobacterium avium complex感染，開始給予口服doxycycline 200mg/ day。一年半後，皮膚症狀顯著改善，只剩下癒合後的疤痕，遂停藥；且在八個月後無復發的情形。

並列摘要

We report a case of cutaneous atypical mycobacteriosis in a 30-year-old female due to Mycobacterium avium complex. The skin lesions were three enlarging subcutaneous tender nodules with ulceration over right thigh and knee in a sporotrichoid pattern. Histopathological examination revealed irregular epidermal hyperplasia with a dense mixed cell infiltrate composed of neutrophils, lymphocytes, plasma cells, eosinophils and multi-nucleated giant cells. The Gomori methenamine silver stain fails to detect spores in the dermis. The Acid-fast stain and Gram stain were also negative. Under the impression of sporotrichosis, the patient received oral potassium iodide 3g/ day for 1 month. However, has cutaneous lesions because worse gradually. The polymerase chain reaction-based method suggested an infection caused by an M. avium complex. Patient’s skin lesions completely cured after receiving doxycycline 200 mg / day for one and half a year. There is no evidence of recurrence 8 months after stopping medication.

並列關鍵字

Atypical mycobacteriosis ； Mycobacterium avium ； Sporotrichoid Doxycycline