脓肿分枝杆菌感染肉芽肿1例

A Case of Mycobacterium Abscessus Granuloma

患者女,44岁。双侧耳下及颈部反复出现丘疹、结节、斑块3年余,加重2个月。皮肤科情况:双侧耳垂周围、下颌、颈部可见密集分布的红色丘疹、结节、斑块,部分结节斑块上可见窦道,挤压后有黄色脓性分泌物流出。双小腿可触及数处皮下结节及肿块。皮损组织病理示:真皮内弥漫性混合炎症细胞浸润,PAS(-),抗酸染色弱阳性。组织培养:血培养基上见圆形乳白色酵母样菌落。菌落反向线点杂交分子生物学鉴定:脓肿分枝杆菌。诊断:脓肿分枝杆菌感染肉芽肿。

A 44-year-old female presented papules and nodules and plaques under both ears and neck for more than three years and aggravated for two months.Dermatological examination showed sinus tracts on the nodules and plaques,and yellow purulent secretions discharged through some of them after extrusion.Several red subcutaneous nodules and masses could be touched on both legs.Histopathological examination revealed diffuse infiltration of mixed inflammatory cells in the dermis,PAS staining was negative and acid-fast staining was weak positive.There were yeast-like colonies growing on the blood cultures.The isolate was identified as mycobacterium abscess by the reverse linear dot hybridization method.Mycobacterium abscessus granuloma was diagnosed.