| 摘要: |
| 目的:探讨罗德西亚分枝杆菌肺病的临床特征、治疗及预后,提高临床对该病的认识。方法:回顾性分析1 例儿童罗德
西亚分枝杆菌肺病的临床资料,并复习相关文献。结果:患儿,男,5 岁5 个月,主要表现为胸痛、高热,右下肺叩诊实音、呼吸音
减弱,肺部CT 显示右侧胸腔积液,右中、下叶渗出性病灶,支气管肺泡灌洗液二代测序显示罗德西亚分枝杆菌。初始予阿奇霉
素及利奈唑胺抗非结核分枝杆菌(NTM)治疗,2 个月后肺部CT 示病灶加重,加用利福平组成三联方案,随后肺部体征及肺部
CT 逐渐改善。三联抗NTM 治疗12 个月后停药,随访24 个月无异常。文献复习共3 例患者(男2 例,女1 例;儿童1 例,成人2
例),均有发热,感染部位包括肺部、腹腔及中枢神经系统,均通过二代测序确诊。所有患者均予以大环内酯类为基础的抗NTM
治疗方案(2 例三联,1 例二联),治疗3~15 个月,预后良好。结论:罗德西亚分枝杆菌肺病罕见,二代测序有助于明确病原体,
采用基于大环内酯类药物的抗NTM 治疗方案效果显著且患儿预后好。 |
| 关键词: 罗德西亚分枝杆菌 肺病 非结核分枝杆菌 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.07.009 |
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| 基金项目:广东省自然科学基金,编号2021A1515011589;广东医科大学青年培育基金,编号GDMUQ2022018。 |
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| Pulmonary Disease Induced by Mycobacterium Rhodesiae in a Child: a Case Report and Literature Review |
| Ke Chuanghong, Huang Zirong, Liu Xiaohua, Ao Dang, Han Huanqin |
| ((The Affiliated Hospital of Guangdong Medical
University, Guangdong Zhanjiang 524001, China)) |
| Abstract: |
| Objective: To probe into the clinical characteristics, treatment, and prognosis of pulmonary disease induced by Mycobacterium
rhodesiae, and to improve the clinical understanding of the disease. Methods: Retrospective analysis was performed on clinical data of a
child with pulmonary disease induced by M. rhodesiae, and relevant literature was reviewed. Results: The patient was a 5-year-and-5-
month-old boy presenting with chest pain and high fever. Physical examination revealed dullness to percussion and markedly diminished
breath sounds in the right lower lung. Chest CT showed right-sided pleural effusion and exudative lesions in the right middle and lower
lobes. Next-generation sequencing of bronchoalveolar lavage fluid identified M. rhodesiae. Initially, treatment for non-tuberculous
mycobacteria (NTM) was initiated with azithromycin and linezolid. Two months later, the lung CT lesions worsened, rifampicin was added
to form a triple therapy regimen, followed by gradual clinical and radiological improvement. The triple therapy for NTM was discontinued after 12 months, and no abnormality was observed during 24 months of follow-up. A total of 3 patients (2 males and 1 female; 1 child and
2 adults) were identified. All patients presented with fever, with infection sites including the lung, abdominal cavity, and central nervous
system. The pathogen was identified via next-generation sequencing in all cases. All patients received the macrolide-based anti-NTM
regimen (2 patients received a triple therapy regimen, and 1 patient received a two-drug regimen). Treatment duration ranged from 3 to 15
months, and all patients had a favorable prognosis. Conclusion: Pulmonary disease induced by M. rhodesiae is rare. Next-generation
sequencing facilitates pathogen identification, and macrolide-based anti-NTM regimens yield favorable prognosis. |
| Key words: Mycobacterium rhodesiae pulmonary disease non-tuberculous mycobacteria children |
