敗血症様症状を呈した患者の流血中よりRunyon II群抗酸菌を頻回に証明しえた1症例について

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We recently experienced an interesting case having persistent fever of unknown origin, and acid-fast bacilli of Runyon Group II were frequently demonstrated in circulating blood. A clinical and bacteriological study was made. The patient is a 31-year-old housewife. She developed a high fever accompanied by shaking chills. Gram-positive bacilli were demonstrated once in the circulating venous blood, but following administration of antibiotics bacteria could not be detected and fever subsided. Thereafter fever recurred, and despite various therapies fever persisted. At the time of admission, acid-fast bacilli of Runyon Group II were isolated from the venous blood and furthermore the patient had a high fever. of 39°C-40°C and complained of general malaise, and diarrhea and cough during high fever, but sputum, chest pain and skin eruption could not be observed. Swelling of the cervical, inguinal, and axillary lymph nodes were noted together with enlargement of the liver and spleen. Pigmentation having a dia meter of about 10-15cm was noted on the left leg and it was accompanied by induration, erythema, and pain. Clinical and bacteriological examinations suggested malignant lymphoma and septicemia due to acid-fast bacilli. After February 1972 in addition to anti tuberculosis therapy given heretofore, treatment for malignant limphoma was commenced, and acid-fast bacilli detected over a period of 10 months from the venous blood could no longer be isolated and the patients condition improved. During the 12-month period from 28 May 1971 to 26 April 1972 bacteriological tests were performed. 37 times, and only scotochromogenic acid-fast bacilli could be isolated on 25 occasions. Being all retarded in growth, they were considered as belonging to Runyon Group II strain. Study made of the strains isolated from 28 May 1971 to 7 September 1971 indicated that their characteristics were consistent ivith those of M. scrofulaceum and M. gordonae. More interesting was the fact that the strains detected on 2, 3, 5, and 21 July 1971 and 11 August 1971 were composed of two types, M. scrofulaceum and M. gordonae. Intradermal response to various types of acid-fast bacilli tuberculin test was negative. Agglutination reaction with the patients serum using an isolated bacterium of M. gordonae was 512 fold. The value is higher than that of serum of a healthy individual, suggesting that this strain might have some pathogenic significance. In this patient having malignant lymphoma as an underlying disease, septicemia-like symptoms developed during the course of the disease probably due to M. scrofulaceum and M. gordonae.
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敗血症様症状を呈した患者の流血中よりRunyon II群抗酸菌を頻回に証明しえた1症例について

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