Mycobacterium haemophilum Masquerading as Leprosy in a Renal Transplant Patient
Mycobacterium haemophilum Masquerading as Leprosy in a Renal Transplant Patient
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肾移植患者体内的嗜血分枝杆菌伪装成麻风病
DOI：
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发表时间：
2013
影响因子：
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通讯作者：
T. Ferguson
中科院分区：
文献类型：
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作者：
Nathanial K. Copeland;N. Arora;T. Ferguson
实体器官移植（SOT）患者免疫抑制后的肠道感染是常见的并发症，皮肤是常见的感染部位。非结核分枝杆菌（NTM）是SOT患者皮肤感染的罕见但潜在的原因。我们报告一位肾移植后出现免疫抑制的成年男性，在几个月内出现无症状的皮疹。病人的皮疹包括丘疹和斑块合并成一个环形的形成。在最初的经验性治疗失败后，进行了穿刺活检，证实神经受累疑似麻风分枝杆菌。然而，活检标本的培养物生长抗酸杆菌，随后被鉴定为M。嗜血菌他的皮疹改善后，克拉霉素和环丙沙星的长期课程。这两种微生物都是机会性皮肤感染的潜在原因，并且由于对皮肤的相似偏好以及其他生化和遗传相似性而难以区分。最终可以用文化来区分它们，如M。嗜血杆菌能在培养基中生长，M.麻风病人不会。这是一个独特的病例，因为神经受累的活检是典型的麻风活检。
Opportunistic infections following immunosuppression in solid organ transplant (SOT) patients are common complications with the skin being a common sight of infection. Nontuberculous mycobacteria (NTM) are rare but potential causes of skin infection in SOT patients. We present a case of an adult male immunosuppressed following renal transplantation who presented with an asymptomatic rash for several months. The patient's skin eruption consisted of erythematous papules and plaques coalescing into an annular formation. After failure of the initial empiric therapy, a punch biopsy was performed that demonstrated nerve involvement suspicious for Mycobacterium leprae. However, culture of the biopsy specimen grew acid-fast bacilli that were subsequently identified as M. haemophilum. His rash improved after a prolonged course of clarithromycin and ciprofloxacin. Both organisms are potential causes of opportunistic skin infections and can be difficult to distinguish with similar predilection for skin and other biochemical and genetic similarities. Ultimately they can be distinguished with culture as M. haemophilum will grow in culture and M. leprae will not. This case was unique due to nerve involvement on biopsy which is classically seen on biopsies of leprosy.