中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (4): 230-233.doi: 10.12144/zgmfskin202604230

• 新发与再发感染性皮肤病 • 上一篇    下一篇

膜性肾病患者放线菌皮肤感染一例

王艺锦,梁斌,闫仟叶,张敏,吕佳冰   

  1. 空军特色医学中心，北京，100142
  • 出版日期:2026-04-15 发布日期:2026-04-07

Cutaneous actinomycosis in a patient with membranous nephropathy: a case report

WANG Yijin, LIANG Bin, YAN Qianye, ZHANG Min, LYU Jiabing   

  1. The Air Force Medical Center, Beijing 100142, China
  • Online:2026-04-15 Published:2026-04-07

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摘要： 本文报道国内外罕见的以双下肢脓点、脓湖为主要表现的放线菌皮肤感染一例。患者，男，27岁，膜性肾病10年，双下肢硬结、破溃、伴黄色脓液渗出伴疼痛2年，间断发热伴剧烈疼痛3个月，多种药物治疗效果欠佳，且病情加重，脓液及组织培养提示葡萄球菌、放线菌阳性；mNGS证实放线菌感染。由于患者对青霉素和莫西沙星过敏，给予口服多西环素联合利福平治疗，17天后皮损明显改善。

关键词: 膜性肾病, 放线菌皮肤感染

Abstract: Cutaneous actinomycosis manifesting as pustules and pus lakes on both lower extremities is rare at home and abroad. We herein report one such case. A 27-year-old male had a 10-year history of membranous nephropathy. He presented with induration, ulceration, yellow pus discharge and pain in both lower extremities for 2 years. The rash subsequently spread to the trunk and upper limbs, accompanied by intermittent fever and severe pain for 3 months. Multiple treatments showed unsatisfactory efficacy, and the condition deteriorated. Pus and tissue cultures were positive for Staphylococcus and Actinomyces. Metagenomic next-generation sequencing (mNGS) confirmed Actinomyces. Due to the patient's allergy to penicillin and moxifloxacin, oral doxycycline combined with rifampicin was administered. Skin lesions improved significantly after 17 days of treatment.

Key words: membranous nephropathy, cutaneous actinomycosis