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报告1例少见的播散性粗糙型脓肿分枝杆菌皮肤感染。患者女,16岁。因四肢播散性红斑、结节,伴反复发热、盗汗及淋巴结增大就诊。皮肤科检查:四肢散在数个暗红色斑,可触及蚕豆至鹌鹑蛋大皮下结节;左膝关节一4 cm×3 cm溃疡面。实验室及辅助检查:血常规中WBC及血红蛋白均下降;左膝关节溃疡分泌物涂片:抗酸染色阳性(++);血平皿培养:表现为粗糙型菌落形态;16S rRNA基因和RNA聚合酶β亚单位rpoB基因序列测定提示为脓肿分枝杆菌。诊断:播散性粗糙型脓肿分枝杆菌皮肤感染。予静脉滴注丁胺卡那霉素及口服克拉霉素治疗1年后痊愈。
Report of a rare case of disseminated rough abscess mycobacterial skin infections. Female patient, 16 years old. Due to disseminated erythema limbs, nodules, with repeated fever, night sweats and lymph nodes increase treatment. Dermatology examination: scattered in the limbs several dark red spots, reaching broad beans to quail eggs subcutaneous nodules; left knee a 4 cm × 3 cm ulcer surface. Laboratory and laboratory examinations: blood WBC and hemoglobin decreased; left knee ulcer secretions smear: acid-fast staining (++); blood plate culture: the performance of rough colony morphology; 16S rRNA gene and RNA polymerization Enzyme β subunit rpoB gene sequence analysis suggested Mycobacterium abscess. Diagnosis: disseminated rough abscess mycobacterial skin infections. After intravenous infusion of amikacin and oral clarithromycin treatment recovered after 1 year.