海分枝杆菌皮肤病1例  

Skin disease caused by Mycobacterium marinum:a case report

作　　者：宋晓玲 徐建国 魏永利[1] 陈庆美 Song Xiaoling;Xu Jianguo;Wei Yongli;Chen Qingmei(Department of Infectious Diseases,Linyi People′s Hospital,Linyi 276000,China;Department of Emergency Medicine,Linyi People′s Hospital,Linyi 276000,China)

机构地区：[1]临沂市人民医院感染科,临沂276000 [2]临沂市人民医院急诊内科,临沂276000

出　　处：《中华结核和呼吸杂志》2024年第9期851-853,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：海分枝杆菌感染常侵犯四肢末端,引起单发或多发皮损,随着分子检测技术的提高以及NGS病原检测的临床应用,海分枝杆菌皮肤病的诊断率在逐渐提高。本文报道1例54岁男性,被海鱼刺伤手部后,右手及右上肢逐渐出现肿胀及结节,通过脓液的结核分枝杆菌耐药基因溶解曲线检测及菌种鉴定,诊断为海分枝杆菌感染。给予口服利福平联合克拉霉素和米诺环素抗感染治疗,随访中脓肿及结节逐渐缩小,最终消失。希望通过对该病例诊断及治疗的介绍,提高临床医生对本病的认知,避免误诊、漏诊。Mycobacterium marinum infection often affects the extremities,causing single or multiple skin lesions.With the improvement of molecular detection technology and the clinical application of NGS pathogen detection,the diagnosis rate of Mycobacterium marinum skin disease is gradually increasing.This article reported the case of a 54-year-old man who was stung by a marine fish and gradually developed swelling and nodules on his right hand and right upper limb.He was diagnosed with Mycobacterium marinum infection by detection of the tuberculosis resistance gene dissolution curve of the pus and the identification of the bacteria.Oral rifampicin combined with clarithromycin and minocycline was given for anti-infection treatment.During follow-up,the abscesses and nodules gradually shrank and eventually disappeared.By presenting the diagnosis and treatment of this case,the understanding of this disease among clinicians can be improved to avoid misdiagnosis and missed diagnosis.

关 键 词：分枝杆菌感染 四肢末端 海分枝杆菌 临床医生 米诺环素 分子检测技术 皮肤病 菌种鉴定 

分 类 号：R754[医药卫生—皮肤病学与性病学]