海分枝杆菌致游泳池肉芽肿

A case of swimming pool granuloma caused by Mycobacterium marinum

报告1例海分枝杆菌致游泳池肉芽肿。患者女,66岁。右手背及手腕结节1个月,有右拇指鱼刺刺伤史。皮肤科检查:右手背一淡紫红色结节,直径约4 cm,高出皮面,其上干燥、脱屑,中央破溃伴黄色脓液,质韧,边界不清;右手腕一淡红色结节,稍高出皮面,直径约8 mm,界不清,无压痛。皮损组织病理检查:表皮大致正常,真皮内可见中性粒细胞性脓疡形成,外围淋巴细胞及组织细胞浸润,偶见多核巨细胞。抗酸染色及结核感染T细胞斑点试验(T-SPOT.TB)均阳性,微生物培养及16 S测序示海分枝杆菌。诊断:游泳池肉芽肿。

A case of swimming pool granuloma caused by Mycobacterium marinum is reported.A 66-year-old female presented with a one-month history of nodules on the right hand and wrist.The lesions occurred after fish bone injury.Physical examination revealed a subcutaneous dark-red nodule(about 4 cm in diameter)on the back of the right hand,which showed dryness,flakes,central rupture and yellow pus,tough and unclear boundary,as well as a reddish subcutaneous nodule(8 mm in diameter)on the right wrist.Histopathological examination showed that the epidermis was generally normal.The dermis showed neutrophil abscess,infiltration of peripheral lymphocytes and histiocytes,and sporadic polynuclear giant cells.The patient showed positive results in acid-fast staining and T-SPOT.TB test.Mycobacterium marinum was isolated from the lesional tissue.16 sequencing also confirmed the result.The diagnosis of swimming pool granuloma was established.