一个罕见的遭遇:一个免疫抑制的移植后患者的结核性肌肉炎
Sai Kavya Sree1, Stephen Raj1, Mani Bhushan Kumar1
1Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian journal of medical microbiology
|January 24, 2025
概括
结核性肺结核炎是一种罕见的肺外结核病,发生在一个移植后的患者身上. 早期诊断和抗结核疗法治疗对于管理这种不常见的感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是一门学科.
背景情况:
- 肺外结核 (EPTB) 可以表现为各种形式,结核性肺炎异常罕见.
- 脊髓移植后接受者免疫力低下,增加他们对机会性感染的易感性,包括结核病.
研究的目的:
- 在移植接受者中报告一种罕见的结核性肌肉炎病例.
- 突出诊断挑战和成功管理这种不常见的EPTB形式.
- 强调考虑EPTB在具有非典型表现的免疫功能低下患者中的重要性.
主要方法:
- 一个34岁的男性移植接受者的病例报告显示,他患有关节疼痛和发烧.
- 诊断工作包括MRI,使用Ziehl-Neelsen染色的超声波导向吸收和GeneXpert MTB测试.
- 治疗包括抗结核疗法 (ATT) 和的手术疏通.
主要成果:
- 核磁共振扫描显示,左部区域存在局部高强度病变.
- 吸入产生了性排泄,对酸性菌呈阳性.
- 基因Xpert MTB证实Mycobacterium 结核病对利芬素敏感. 基因Xpert MTB证实Mycobacterium 结核病对利芬素敏感.
- 通过ATT和液排水成功进行治疗.
结论:
- 结核性肌肉炎是一种罕见的,但在移植患者中可能出现的并发症.
- 多模式成像和分子诊断 (GeneXpert MTB) 对于早期和准确的诊断至关重要.
- 迅速启动ATT和源控制 (排水) 会带来有利的结果.
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