【摘要】 患者，男，53岁。右上肢结节半年。皮肤科查体：右上肢见多发暗红色丘疹、结节，部分结节破溃，可见脓血性分泌物，伴右手肿胀，皮温正常，轻度压痛。皮肤组织病理检查符合感染性肉芽肿；组织分枝杆菌培养为海分枝杆菌；海分枝杆菌qPCR(组织)为阳性，B超提示右手指伸肌腱腱鞘炎，结合临床表现及实验室检查诊断为海分枝杆菌感染。给予米诺环素、克拉霉素治疗2个月，效果欠佳，结合药敏结果调整方案为利福平、克拉霉素、多西环素、氨苯砜治疗，5个月后右上肢丘疹、结节基本消失。更多还原

【Abstract】 A 53-year-old male presented with nodules on the right upper limb for half a year. Dermatological examination revealed several dark red papules and nodules on the right upper limb, some of which were ruptured with purulent and bloody secretions. The right hand was swollen with normal skin temperature and mild tenderness. Histopathology examination revealed infectious granuloma. Tissue mycobacteria culture revealed Mycobacterium marinum. Mycobacterium marinum qPCR(tissue) was positive. Mycobacterium marinum infection was diagnosed based on clinical manifestations and laboratory tests. Minocycline and clarithromycin were given for two months with poor results. The treatment regimen was adjusted to rifampicin, clarithromycin, doxycycline, and dapsone based on the drug sensitivity results. The papules and nodules on the right upper limb extremity basically disappeared after five months.更多还原