NEJM:播散性放线菌病-病例报道

2018-09-13 xing.T MedSci原创

该患者被诊断为播散性放线菌病,这是一种由放线菌引起的罕见、缓慢进展的细菌感染,可表现为感染组织中多个脓肿和含硫颗粒的形成。

患者为一名58岁男子,因前3个月内咳嗽和体重减轻10公斤到呼吸科门诊就诊。他是一名吸烟者,在过去的4年里,曾在一家加工棉花的工厂工作。



体格检查无发热,肺部听诊时呼吸音正常。胸部和腹部计算机断层扫描显示多个肺结节(如图A所示)与心包积液,两肺胸腔积液和多处肝脏病变。医务人员采用电视辅助胸腔镜手术进行肺活检。沿支气管束可观察到含有放线菌病特征含硫的颗粒状多个病灶(如图B和C所示,图C展示了图B中圆圈区域的近视图;用苏木精和曙红染色)。在银染色上突出显示丝状细菌(如图D所示)。

该患者被诊断为播散性放线菌病,这是一种由放线菌引起的罕见、缓慢进展的细菌感染,可表现为感染组织中多个脓肿和含硫颗粒的形成。

患者静脉注射高剂量青霉素治疗4周,然后口服阿莫西林延长治疗疗程。

原始出处:


Yan Xu, et al.Disseminated Actinomycosis.N Engl J Med 2018; https://www.nejm.org/doi/full/10.1056/NEJMicm1802090

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    2022-01-03 病毒猎手

    #放线菌病#比较少见,值得记录

    0

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    2019-06-29 howi
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    2018-09-14 Jackie Li

    学习

    0

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    2018-09-13 医者仁心5538

    学习了

    0