以足底感染为首发表现的血行播散性结核1例报道  

Haematogenic disseminated tuberculosis with initial manifestation of foot infection:a case report

作　　者：金文婷 张尧 黄英男 陈翔[2] 林佳冰 胡必杰 潘珏[1] JIN Wen-ting;ZHANG Yao;HUANG Ying-nan;CHEN Xiang;LIN Jia-bing;HU Bi-jie;PAN Jue(Department of Infectious Diseases,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Hospital Infection Management,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院感染病科,上海200032 [2]复旦大学附属中山医院医院感染管理科,上海200032

出　　处：《复旦学报（医学版）》2022年第2期313-316,共4页Fudan University Journal of Medical Sciences

基　　金：复旦大学附属中山医院青年基金(2021ZSQN29)。

摘　　要：报道1例以左足底局部感染起病的血行播散性结核病例的临床、影像及诊治过程。血行播散性结核发病率低,仅占结核病的1%~2%,临床表现多样且非特异性,诊断非常困难。本例通过宏基因二代测序技术,在外周血检测到结核分枝杆菌复合群,为早期诊断结核病提供了非常重要的病原依据。后续骨髓活检、淋巴结活检病理提示肉芽肿,痰、左足脓液、淋巴结组织均培养到结核分枝杆菌,最终明确诊断为血行播散性结核。We reported the clinical feature,diagnosis and treatment of a case of haematogenic disseminated tuberculosis initially presenting with foot infection.Hematogenous disseminated tuberculosis has a low incidence,accounting for only 1%-2%of tuberculosis.Its clinical manifestations are non-specific and varied,making it difficult to diagnosis.In this case,the Mycobacterium tuberculosis complex was detected in the peripheral blood by the metagenomic next-generation sequencing,which provided a very important pathogenic basis for the early diagnosis of tuberculosis.Subsequently,bone marrow biopsy and lymph node biopsy pathology showed granuloma.Culture results of sputum,left foot pus and lymph node were all Mycobacterium tuberculosis positive.Finally,hematological disseminated tuberculosis was confirmed.

关 键 词：血行播散性结核 粟粒性结核 宏基因二代测序 

分 类 号：R52[医药卫生—内科学]