不见但难以忘怀 - - 肌肉的格拉姆染色体中的折射性细菌
Bruno Tiago Carvalho1,2, Sara Velho Meirinhos3, Gonçalo Jantarada Domingos3
1Clinical Pathology Department, Hospital Santa Maria, Unidade Local de Saúde Santa Maria, Lisboa, Portugal. bruno.carvalho@campus.ul.pt.
概括
这一案例凸显了在免疫抑制患者中诊断肌肉结核病的挑战. 早期识别使用专用染料如Auramine和Kinyoun对于及时治疗Mycobacterium结核病至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 由于免疫抑制疗法,艾滋病毒和移民,结核病流行病学正在发生转变.
- 肺外结核和肌肉结核很少见,尤其是在没有骨参与的情况下.
- 免疫抑制患者有较高的非典型结核病呈现的风险.
研究的目的:
- 在免疫抑制患者中报告一种罕见的肌肉结核病病例.
- 强调诊断挑战和早期识别的重要性.
- 突出特定染色技术在诊断具有挑战性的病例中的实用性.
主要方法:
- 一个65岁的男性患有急性髓性白血病的案例介绍.
- 初始呈现与怀疑大腿感染,经验性地用抗生素治疗.
- 诊断工作包括CT扫描,超声导向吸收,Gram染色,Auramine/Kinyoun染色和RT-PCR.
主要成果:
- 最初的格拉姆染色显示中性粒细胞和幽灵格拉姆细菌;培养是负的.
- 奥拉明和金云染色证实了酸性菌.
- 通过RT-PCR检测出了Mycobacterium tuberculosis,从而进行了向治疗.
结论:
- 肌肉结核病可以在免疫抑制的个体中呈现异常.
- 标准培养可能是负的,需要专门的染色 (Auramine,Kinyoun) 和分子方法 (RT-PCR) 进行诊断.
- 在这种高风险人群中,及时诊断和治疗至关重要.
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