播散性皮肤鸟分枝杆菌感染

A case of disseminated cutaneous infection by Mycobacterium avium

报告1例少见的播散性皮肤鸟分枝杆菌感染患者。患者女,67岁。双侧乳房及左上肢皮肤水疱、囊性肿物及溃疡5个月余。皮肤科检查:双侧乳房及左上肢有结节及溃疡,表面有坏死组织及脓液。皮损组织病理:真皮深部见一巨大无包膜的炎性结节,其内炎性细胞主要为中性粒细胞、浆细胞、组织细胞及淋巴细胞构成,抗酸染色可见大量抗酸杆菌,溃疡面胶冻状内容物培养可见黄色光滑菌落生长,经聚合酶链反应(PCR)检测结果鉴定为鸟分枝杆菌。诊断:播散性皮肤鸟分枝杆菌感染。

A rare case of disseminated infection by Mycobacterium avium is reported. A 67-year-old female was admitted because of disseminated ulcerations on her breasts and left arm for 5 months. Dermatological examination showed nodules, necrosis and ulcers with pus on the breasts and left arm. Skin biopsy of a nodule revealed inflammatory modular infiltration of neutrophils, plasmocytes, histiocytes and lymphocytes in the dennis. Acid-fast bacilli staining was positive. Mycobacterial cultures of the jelly-like contents from skin lesions yielded colonies of Mycobacterium avium, identified by PCR. A diagnosis of Mycobacterium avium infection was made.