封闭治疗致脓肿分枝杆菌感染3例

Three cases of Mycobacterium abscessus infection following block therapy

目的:总结脓肿分枝杆菌感染的诊疗过程及转归,以提高对本病的认识。方法:分析封闭治疗后出现脓肿分枝杆菌感染病例3例,并结合相关文献进行分析。结果:3例病例均存在皮肤软组织感染,1例合并骨髓炎,1例合并膝关节感染,1例引起肩胛背脓肿。分泌物培养为快速生长型非结核分枝杆菌,其中病例1鉴定为脓肿分枝杆菌massiliense亚种感染。3例患者予清创及“克拉霉素+阿米卡星+头孢西丁(或亚胺培南)+莫西沙星”治疗,均好转出院。结论:涉及深部组织的脓肿分枝杆菌感染病例报道较少,鉴定到亚种水平的治疗有利于达到预期疗效。

Objective:To report the diagnosis,treatment and outcome of mycobacterium abscess infection,and improve the understanding of the disease.Methods:Three cases of mycobacterium abscess infection after closed treatment were reported,and analyzed in combination with relevant literatures.Results:All the 3 cases had skin soft-tissue infection,1 case with osteomyelitis,1 case with knee joint infection,and 1 case with scapular abscess.Rapidly growing non-tuberculous Mycobacterium was cultured from the secretions,and case 1 was identified as the infection of Mycobacterium abscess massiliense.Debridement and ’clarithromycin+amikacin+cefoxitin(or imipenem)+moxifloxacin’ were given,and all the patients were relieved and discharged.Conclusion:There were fewer cases of mycobacterium abscess infections involving deeper areas,treatments identifying to subspecies levels were beneficial in achieving desired outcomes.