皮肤苏尔加分枝杆菌感染一例  

A case of skin infection caused by Mycobacterium szulgai

作　　者：王小坡[1] 陈志明[2] 宋昊[1] 孙建方[1] 王洪生[2] 

机构地区：[1]中国医学科学院 北京协和医学院 皮肤病医院病理科,南京210042 [2]中国医学科学院 北京协和医学院 皮肤病医院麻风分枝杆菌实验室,南京210042

出　　处：《中华皮肤科杂志》2016年第10期724-726,共3页Chinese Journal of Dermatology

摘　　要：患儿女，7岁，因左侧面部斑块4年就诊。皮肤科检查：左侧面部见6cm×5cm境界清楚环状斑块，质韧，无明显触痛，皮损表面可见脓痂。组织病理：表皮部分破溃、坏死，真皮内弥漫性淋巴、组织细胞及上皮样细胞浸润，局灶伴较多嗜中性粒细胞。过碘酸雪夫染色（PAS）阴性、抗酸染色阴性。组织培养25 d后见暗产色分枝杆菌菌落。菌落涂片抗酸染色阳性。PCR扩增16S rRNA、hsp65基因产物发现与苏尔加分枝杆菌同源性最接近，分别为100%、99%。给予利福平、异烟肼、乙胺丁醇治疗后好转。A 7-year-old girl presented with a plaque on the left side of the face for 4 years. Skin examination revealed a well-marginated circular firm plaque measuring 6 cm × 5 cm in size on the left side of the face with purulent crusts on the surface, which was nontender to palpation. Histopathologic study showed ulceration and necrosis in some areas in the epidermis, diffuse dermal infiltration of lymphocytes, histiocytes and epithelioid cells with the presence of many neutrophilic granulocytes in some regions. Both periodic acid-Schiff（PAS）staining and acid-fast staining were negative. After 25 days of tissue culture, scotochromogenic Mycobacterium colonies grew, and colony smears showed positive acid-fast staining. The sequences of 16S rRNA and hsp65 genes of the fungal isolate showed 100%and 99%homology with those of Mycobacterium szulgai, respectively. After the treatment with rifampicin, isoniazid and ethambutol, the patient′s condition was improved.

关 键 词：皮肤 非结核分枝杆菌 感染 苏尔加分枝杆菌 16S RRNA HSP65 

分 类 号：R754[医药卫生—皮肤病学与性病学]