psk1 virulence gene-induced pulmonary and systemic tuberculosis in a young woman with normal immune function:A case report  

作　　者：Fan Wu Bin Yang Yan Xiao Li-Li Ren Hong-Yi Chen Xin-Lan Hu Yan-Yu Pan Yu-Sheng Chen Hong-Ru Li 

机构地区：[1]Department of Respiratory and Critical Care Medicine,Shengli Clinical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou University Affiliated Provincial Hospital,Fuzhou 350001,Fujian Province,China [2]NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory,Institute of Pathogen Biology,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China [3]Emergency Department,Shengli Clinical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou University Affiliated Provincial Hospital,Fuzhou 350001,Fujian Province,China [4]Clinical Microbiology Laboratory,Shengli Clinical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou University Affiliated Provincial Hospital,Fuzhou 350001,Fujian Province,China [5]Infection Department,The 900th Hospital of the PLA Joint Support Force,Fuzhou 350001,Fujian Province,China [6]Department of Infectious Diseases,Shengli Clinical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou University Affiliated Provincial Hospital,Fuzhou 350001,Fujian Province,China

出　　处：《World Journal of Clinical Cases》2024年第35期6826-6833,共8页世界临床病例杂志（英文）

基　　金：Supported by the Research on Intelligent Recommendation Decision Model of Geriatrics Based on Big Data,No.2021CX01010136.

摘　　要：BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new cases annually.This case report des-cribes the investigation of a case of severe disseminated tuberculosis in a young adult with normal immune function,conducted to ascertain why a Mycobacterium tuberculosis(M.tuberculosis)strain caused such severe disease.CASE SUMMARY A previously healthy 28-year-old woman presented to our hospital with a 1-mo-nth history of fever and fatigue.She was diagnosed with severe disseminated pulmonary tuberculosis,spinal tuberculosis with paravertebral abscesses,and tuberculous meningitis.M.tuberculosis was isolated from bronchoal-veolar lavage fluid.She was treated with standard antituberculous therapy and underwent debridement,bone graft,and internal fixation surgery for spinal tuberculosis.She responded to therapy and regained her ability to walk following the surgery.We analysed the whole-genome sequence of the strain and designated it BLM-A21.Additional M.tuberculosis genomes were selected from the Virulence Factor Database(http://www.mgc.ac.cn/cgi-bin/VFs/genus.cgi?Genus=Mycobacterium)for comparison.An evolutionary tree of the BLM-A21 strain was built using PhyML maximum likelihood software.Further gene analysis revealed that,except for the pks1 gene,BLM-A21 had similar virulence genes to the CDC 1551 and H37Rv strains,which have lower dissemination.CONCLUSION We speculate that the pks1 virulence gene in BLM-A21 may be the key virulence gene responsible for the wide-spread dissemination of M.tuberculosis infection in this previously healthy adult with normal immune function.

关 键 词：Mycobacterium tuberculosis Disseminated tuberculosis Spinal tuberculosis Tuberculous meningitis Virulence gene Whole-genome sequencing Case report 

分 类 号：R521[医药卫生—内科学]