中国麻风皮肤病杂志 ›› 2024, Vol. 40 ›› Issue (5): 352-354.doi: 10.12144/zgmfskin202405352

• 病例报告 • 上一篇    下一篇

累及皮肤和肌腱的难治性海分枝杆菌感染一例

张欣然1,2,3,赵晴2,3,于长平2,3,周桂芝2,3,张福仁1,2,3   

  1. 1山东大学，山东济南，250000；2山东第一医科大学附属皮肤病医院，山东济南，250022；3山东省皮肤病性病防治研究所，山东济南，250022
  • 出版日期:2024-05-15 发布日期:2024-04-22

Refractory Mycobacterium marinum infection involving skin and tendons: a case report

ZHANG Xinran1,2,3, ZHAO Qing2,3, YU Changping2,3, ZHOU Guizhi2,3, ZHANG Furen1,2,3   

  1. 1 Shandong University, Jinan 250000, China; 2 Hospital for Skin Diseases, Shandong First Medical University, Jinan 250022, China; 3 Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2024-05-15 Published:2024-04-22

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摘要： 患者，男，53岁。右上肢结节半年。皮肤科查体：右上肢见多发暗红色丘疹、结节，部分结节破溃，可见脓血性分泌物，伴右手肿胀，皮温正常，轻度压痛。皮肤组织病理检查符合感染性肉芽肿；组织分枝杆菌培养为海分枝杆菌；海分枝杆菌qPCR（组织）为阳性，B超提示右手指伸肌腱腱鞘炎，结合临床表现及实验室检查诊断为海分枝杆菌感染。给予米诺环素、克拉霉素治疗2个月，效果欠佳，结合药敏结果调整方案为利福平、克拉霉素、多西环素、氨苯砜治疗，5个月后右上肢丘疹、结节基本消失。

关键词: 海分枝杆菌, 感染性肉芽肿

Abstract: A 53-year-old male presented with nodules on the right upper limb for half a year. Dermatological examination revealed several dark red papules and nodules on the right upper limb, some of which were ruptured with purulent and bloody secretions. The right hand was swollen with normal skin temperature and mild tenderness. Histopathology examination revealed infectious granuloma. Tissue mycobacteria culture revealed Mycobacterium marinum. Mycobacterium marinum qPCR (tissue) was positive. Mycobacterium marinum infection was diagnosed based on clinical manifestations and laboratory tests. Minocycline and clarithromycin were given for two months with poor results. The treatment regimen was adjusted to rifampicin, clarithromycin, doxycycline, and dapsone based on the drug sensitivity results. The papules and nodules on the right upper limb extremity basically disappeared after five months.

Key words: Mycobacterium marinum, infectious granuloma