结核T淋巴细胞斑点试验辅助诊断鱼刺伤肉芽肿一例  

T-SPOT.TB assisted in the diagnosis of fish stab wound granuloma: a case report

作　　者：缪梦宇 潘晴[1] 暴芳芳[1] 刘红[1] 张福仁[1] MIAO Mengyu;PAN Qing;BAO Fangfang;LIU Hong;ZHANG Furen(Shandong Provincial Hospital for Skin Diseases&Shandong Provincial Institute of Dermatology and Venereology,Shandong First Medical University,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院(山东省皮肤病医院,山东省皮肤病性病防治研究所),山东济南250022

出　　处：《中国麻风皮肤病杂志》2021年第11期703-705,共3页China Journal of Leprosy and Skin Diseases

基　　金：山东省高等学校青创科技支持计划(编号:2019KJL003);山东第一医科大学学术提升计划(编号:2019LJ002,2019RC007)。

摘　　要：患者,男,65岁。右手拇指肿胀1个月余,脓肿切开引流术后10天。就诊时因切口未愈合,未进行组织病理及组织细菌培养等检查。查血结核T淋巴细胞斑点试验(T-SPOT.TB)阳性。经PPD实验及胸片排除结核杆菌感染后,反复询问病史,疑似带鱼刺伤史,结合病史及T-SPOT.TB高度怀疑鱼刺伤肉芽肿。3周后切口愈合后行病理示炎性肉芽肿改变,组织qPCR海分枝杆菌阳性。最终确诊为海分枝杆菌感染。给予口服克拉霉素治疗,3.5个月后病情痊愈。A 65-year-old male presented with swollen right thumb for more than 1 month,10 days after incision and drainage of abscess.The incision did not heal when visited the doctor,so histopathology and bacteria culture of the tissue were not performed.The patient was tested positive for T-SPOT.TB.The tuberculosis was not considered by chest radiograph and PPD test and the patient had a suspicious history of hairtail fish stabbing.Based on the patient s history and positive result of T-SPOT.TB the diagnosis of Mycobacterium murinum infection were highly suspected.After 3 weeks,the incision was healed and histological examination showed inflammatory granuloma and the tissue qPCR was positive for Mycobacterium murinum.The final diagnosis was Mycobacterium murinum infection.The patient was treated with oral clarithromycin and recovered after 3.5 months.

关 键 词：结核感染T细胞斑点试验 海分枝杆菌感染 

分 类 号：R754.9[医药卫生—皮肤病学与性病学]