全身播散性卡介苗病多次合并机会性感染1例附文献复习  

Recurrent opportunistic infections secondary to systemic or disseminated BCG disease:a case report and literature review

作　　者：陈晓红[1,2] 阮琰[1,2] 林伟[1,2] 严红梅[1,2] 陈国鸿[1,2] 刘坦业[1,2] 

机构地区：[1]福建省福州肺科医院 [2]福建医科大学临床教学医院结核科,福州350008

出　　处：《中国感染与化疗杂志》2009年第6期458-461,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的探讨全身播散性卡介苗病多次合并机会性感染的临床及病原学特征,为诊断和治疗提供依据。方法分析本例自发病以来的系列临床及实验室、影像学等相关资料,结合文献总结其临床特点。结果经BECTEC960培养并菌型鉴定为牛分枝杆菌,复经间歇区寡核苷酸(SPOLIGOTYPING)和PCR对临床分离株与结核分枝杆菌标准株(H37RV)、牛结核分枝杆菌(M.bovis)标准株和卡介苗株作比对,证实为卡介苗株。同时经细胞免疫、体液免疫检测,提示患儿机体免疫功能低下。虽经反复治疗,终未获预期疗效。结论免疫功能低下是全身播散性卡介苗病多次合并机会性感染的成因,预后不佳,应引起警惕。Objective To review the clinical features and etiology of the recurrent opportunistic infections following systemic or disseminated BCG disease to provide data for future diagnosis and therapy. Methods A series of the clinical, laboratory and im- aging data of one patient with recurrent opportunistic infections following systemic or disseminated BCG disease were reviewed and analyzed together with relevant literature reports. Results The isolate was identified as Mycobacterium tuberculosis var bovis by BECTEC 960 culture and specific identification technique. It was confirmed as a BCG strain via spoligotyping and PCR assay to make alignment between the reference TB strain H37RV, M. boris and BCG strain. The results of cellular and humoral immunity assays suggested that the patient was at low level immunity. A number of therapeutic efforts did not result in expected outcome. Conclusions Low-level immunity competence is one of the causes of recurrent opportunistic infections secondary to disseminated Bacillus Calmette-Guerin disease. The outcome of such infections is bad.

关 键 词：播散性卡介苗感染 机会性感染 

分 类 号：R186.2[医药卫生—流行病学]