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致使心周侧侧感染的Mycobacterium avium复合体:一个病例报告
Ting Li1, Qi Wang1, Yuying Lin1
1Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
IDCases
|January 26, 2026
概括
在曾经接受过心脏手术的患者身上发现了一种罕见的跨心周 sinus 的非结核性真菌菌 (NTM) 感染病例. 甲基因组测序证实了Mycobacterium avium复合体 (MAC) 感染,并成功地用抗菌疗法治疗.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 基因组学就是基因组学.
背景情况:
- 非结核菌 (NTM) 是机会性病原体,但很少引起心脏疾病.
- 横向心周鼻是NTM感染的一个不寻常的部位,之前的文档有限.
研究的目的:
- 报告一个罕见的Mycobacterium avium复合体 (MAC) 感染在横向心周鼻腔的病例.
- 突出基因组下一代测序 (mNGS) 和在罕见的NTM感染中进行手术的诊断效用.
主要方法:
- 一个68岁的男性在心脏手术后出现反复发烧的病例报告.
- 用于病变识别的正子辐射断层扫描/计算机断层扫描 (PET/CT).
- 手术切除心周病变,组织病理学和mNGS用于病原体识别.
- 抗菌菌疗法和7个月的随访与连续成像.
主要成果:
- 在横向心周鼻腔中发现了一种超代谢质像病变.
- 组织病理学揭示了颗粒状炎症和酸性细菌.
- mNGS在组织样本中确定了MAC.
- 患者对抗菌根药物治疗有反应,没有观察到复发.
结论:
- 在患有心脏手术史且表现出不明原因的心周/心中病变的患者中,应考虑NTM感染,特别是MAC.
- 手术干预和mNGS是诊断和管理这些罕见的心脏NTM感染的宝贵工具.
- 早期诊断和适当的抗菌菌疗法对于有利的结果至关重要.
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