播散性放线菌病1例报道及文献复习  

A case report of disseminated actinomycosis and literature review

作　　者：刘丽燕[1] 楼俪泓 姜海琼[1] 周新[2] 

机构地区：[1]上海交通大学附属第一人民医院国际医疗保健中心,上海200080 [2]上海交通大学附属第一人民医院呼吸科,上海200080

出　　处：《中国感染与化疗杂志》2012年第6期419-423,共5页Chinese Journal of Infection and Chemotherapy

摘　　要：目的通过病例报道及文献复习探讨放线菌病的临床特点,提高临床医师对该病的认识。方法报告上海交通大学附属第一人民医院收治的播散性放线菌病1例并复习相关文献。结果患者临床表现为发热、头痛、恶心、呕吐伴行走不稳,影像学检查示脑、肺、前列腺多发病灶,多种多次病原学检查阴性。抗感染治疗效果不佳,开颅活检病理示肉芽组织形成伴革兰阳性放射状丝状杆菌,遂诊断为放线菌病。结论放线菌感染罹患率低,而播散性放线菌病临床上更为少见,易误诊为肿瘤或结核,需引起临床医师的重视,以早期诊断、及时治疗,改善预后。Objective To describe the clinical features of acfinomycosis to improve clinicians＇ awareness of the disease. Methods We reported a case of 47-year-old male with disseminated actinomycosis in our hospital and reviewed relevant literature. The patient＇s clinical manifestations included fever, headache, nausea and vomiting associated with ataxic gait. Radiographic exami nation revealed multiple lesions in his brain, lungs and prostate. The results of various pathogenic tests were negative. Results The patient did not respond to anti infective therapy. Craniotomy biopsy showed granulation tissue with gram positive radial filamentous rod bacteria. Actinomycosis was diagnosed on the basis of this finding. Conclusions The incidence of actinomycosis is very low, especially disseminated actinomycosis in clinical setting. It is easily misdiagnosed as a tumor or tuberculosis. Clinicians should pay more attention to early diagnosis and treatment so as to improve the prognosis.

关 键 词：放线菌病 播散性放线菌病 革兰阳性放射状丝状杆菌 

分 类 号：R519.1[医药卫生—内科学]