A case of T-cell large granular lymphocyte leukemia complicated with Mycobacterium avium meningitis together with literature review

doi:10.3969/j.issn.1000-6621.2021.06.019

Abstract

Abstract:

Non-tuberculous mycobacteria (NTM) central nervous system infection is rare in China. The author reported a case of Mycobacterium avium meningitis. The patient was a 44 years old female, admitted to hospital with “diagnosed as T-cell large granular lymphocyte leukemia for more than 3 years, having fever for 1 day”. After admission, cerebrospinal fluid was tested, and Mycobacterium avium was found with cerebrospinal fluid next generation sequencing, then patient was cured with effective treatment for Mycobacterium avium meningitis. By reviewing relevant literature, the author discusses about the treatment of NTM central nervous system infection, reminds clinicians to be alert to the occurrence and severity of NTM disease, to identify the causes as soon as possible and to take necessary intervention measures.

Key words: Mycobacterium avium, Central nervous system infections, Linezolid, Review literature as topic

HONG Piao-ru, JIANG Hui-fang, TAO Die-hong, SU Chuan-yong, GUO Shu-ping, WU Hai-ying, JIANG Yu-xia, YE Ying-yan. A case of T-cell large granular lymphocyte leukemia complicated with Mycobacterium avium meningitis together with literature review[J]. Chinese Journal of Antituberculosis, 2021, 43(6): 631-635. doi: 10.3969/j.issn.1000-6621.2021.06.019

Figures/Tables 1

References 30

[1]	Cassidy PM, Hedberg K, Saulson A, et al. Nontuberculous mycobacterial disease prevalence and risk factors: a changing epidemiology. Clin Infect Dis, 2009,49(12):e124-9. doi: 10.1086/648443. doi: 10.1086/648443 URL
[2]	唐神结, 高文. 临床结核病学. 北京: 人民卫生出版社, 2011: 700-709.
[3]	Henkle E, Winthrop KL. Nontuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med, 2015,36(1):91-99. doi: 10.1016/j.ccm.2014.11.002. doi: 10.1016/j.ccm.2014.11.002 URL
[4]	Lee MR, Chien JY, Huang YT, et al. Clinical features of patients with bacteraemia caused by Mycobacterium avium complex species and antimicrobial susceptibility of the isolates at a medical centre in Taiwan, 2008-2014. Int J Antimicrob Agents, 2017,50(1):35-40. doi: 10.1016/j.ijantimicag.2017.02.016. doi: 10.1016/j.ijantimicag.2017.02.016 URL
[5]	Stewart A. Disseminated Mycobacterium intracellulare from a Deep Cutaneous Infection. Int J Mycobacteriol, 2019,8(1):98-100. doi: 10.4103/ijmy.ijmy_17_19. doi: 10.4103/ijmy.ijmy_17_19 pmid: 30860187
[6]	Ayoade F, Cotelingam J, Joel Chandranesan AS. Disseminated Mycobacterium avium-Intracellulare Complex Infection Presenting with Disseminated Intravascular Coagulation in an AIDS Patient. J Investig Med High Impact Case Rep, 2017,5(4):2324709617740904. doi: 10.1177/2324709617740904. doi: 10.1177/2324709617740904
[7]	Cai R, Qi T, Lu H. Central nervous system infection with non-tuberculous mycobacteria: a report of that infection in two patients with AIDS. Drug Discov Ther, 2014,8(6):276-279. doi: 10.5582/ddt.2014.01047. doi: 10.5582/ddt.2014.01047 URL
[8]	Padmanaban V, Hussein R, Rizk E. Nontuberculous Mycobacterial Infection in Patients with Neurosurgical Hardware: Two Cases and A Review of the Literature. Cureus, 2020,12(3):e7398. doi: 10.7759/cureus.7398. doi: 10.7759/cureus.7398
[9]	Xess AB, Bala K, Panigrahy A, et al. Mycobacterium fortuitum as a cause of acute CNS infection in an immune-competent girl undergoing repeated VP shunt surgeries. BMJ Case Rep, 2019,12(4):e226900. doi: 10.1136/bcr-2018-226900. doi: 10.1136/bcr-2018-226900 URL
[10]	Midani S, Rathore MH. Mycobacterium fortuitum infection of ventriculoperitoneal shunt. South Med J, 1999,92(7):705-707. doi: 10.1097/00007611-199907000-00009. doi: 10.1097/00007611-199907000-00009 pmid: 10414479
[11]	詹丽萍, 阙丽萍, 吴正宙, 等. 儿童白血病合并播散性非结核分枝杆菌病1例. 中国小儿血液与肿瘤杂志, 2020,25(6):350-352. doi: 10.3969/j.issn.1673-5323.2020.06.010. doi: 10.3969/j.issn.1673-5323.2020.06.010
[12]	Sokol L, Loughran TP Jr. Large granular lymphocyte leukemia. Curr Hematol Malig Rep, 2007,2(4):278-282. doi: 10.1007/s11899-007-0038-7. doi: 10.1007/s11899-007-0038-7 URL
[13]	Bareau B, Rey J, Hamidou M, et al. Analysis of a French cohort of patients with large granular lymphocyte leukemia: a report on 229 cases. Haematologica, 2010,95(9):1534-1541. doi: 10.3324/haematol.2009.018481. doi: 10.3324/haematol.2009.018481 URL
[14]	Lamy T, Loughran TP Jr. Clinical features of large granular lymphocyte leukemia. Semin Hematol, 2003,40(3):185-195. doi: 10.1016/s0037-1963(03)00133-1. doi: 10.1016/s0037-1963(03)00133-1 URL
[15]	Pelliccia S, Di Napoli A, Naso V, et al. Very long-lasting remission of refractory T-large granular lymphocytes leukemia and myeloma by lenalidomide treatment. Eur J Haematol, 2013,91(2):183-186. doi: 10.1111/ejh.12141. doi: 10.1111/ejh.12141 URL
[16]	Celen S, Simsek Y, Ozyer S, et al. Effectiveness of emergency cervical cerclage in patients with cervical dilation in the second trimester. Clin Exp Obstet Gynecol, 2011,38(2):131-133.
[17]	徐凯进, 嵇仲康, 胡海洋, 等. 浙江省12个区(县)分枝杆菌菌种鉴定及耐药相关基因特征分析. 中国防痨杂志, 2017,39(2):154-157. doi: 10.3969/j.issn.1000-6621.2017.02.010. doi: 10.3969/j.issn.1000-6621.2017.02.010
[18]	Bodle EE, Cunningham JA, Della-Latta P, et al. Epidemiology of nontuberculous mycobacteria in patients without HIV infection, New York City. Emerg Infect Dis, 2008,14(3):390-396. doi: 10.3201/eid1403.061143. doi: 10.3201/eid1403.061143 URL
[19]	中华医学会结核病学分会, 《中华结核和呼吸杂志》编辑委员会. 非结核分枝杆菌病诊断与治疗专家共识. 中华结核和呼吸杂志, 2012,35(8):572-580. doi: 10.3760/cma.j.issn.1001-0939.2012.08.006. doi: 10.3760/cma.j.issn.1001-0939.2012.08.006
[20]	中华医学会结核病学分会. 非结核分枝杆菌病诊断与治疗指南(2020年版). 中华结核和呼吸杂志, 2020,43(11):918-946. doi: 10.3760/cma.j.cn112147-20200508-00570. doi: 10.3760/cma.j.cn112147-20200508-00570
[21]	邓国防, 付亮, 唐怡敏, 等. 277例非结核分枝杆菌肺病治疗状况分析. 中国防痨杂志, 2017,39(4):391-396. doi: 10.3969/j.issn.1000-6621.2017.04.016. doi: 10.3969/j.issn.1000-6621.2017.04.016
[22]	何国钧, 肖和平. 非结核分支杆菌病治疗的探讨. 中华结核和呼吸杂志, 2000,23(5):275. doi: 10.3760/j:issn:1001-0939.2000.05.007. doi: 10.3760/j:issn:1001-0939.2000.05.007
[23]	Nannini EC, Keating M, Binstock P, et al. Successful treatment of refractory disseminated Mycobacterium avium complex infection with the addition of linezolid and mefloquine. J Infect, 2002,44(3):201-203. doi: 10.1053/jinf.2002.0970. doi: 10.1053/jinf.2002.0970 URL
[24]	Yogev R, Damle B, Levy G, et al. Pharmacokinetics and distribution of linezolid in cerebrospinal fluid in children and adolescents. Pediatr Infect Dis J, 2010,29(9):827-830. doi: 10.1097/INF.0b013e3181df4b9a. doi: 10.1097/INF.0b013e3181df4b9a URL
[25]	李淑娟, 马彦, 张国斌, 等. 利奈唑胺在脑膜炎患者脑脊液中的药动学及药效学研究. 中国药房, 2015,26(17):2339-2341.
[26]	王莎, 贺龙, 刘晓燕, 等. 不同剂量莫西沙星联合抗结核综合治疗对结核性脑膜炎预后及患者生活质量的影响. 现代医学, 2016,44(8):1106-1109. doi: 10.3969/j.issn.1671-7562.2016.08.019. doi: 10.3969/j.issn.1671-7562.2016.08.019
[27]	王桂荣, 魏国梅, 黄明翔, 等. 鸟分枝杆菌临床分离株亚种组成及耐药谱研究. 结核病与肺部健康杂志, 2017,6(2):114-117. doi: 10.3969/j.issn.2095-3755.2017.02.007. doi: 10.3969/j.issn.2095-3755.2017.02.007
[28]	Falagas ME, Rizos M, Bliziotis IA, et al. Toxicity after prolonged (more than four weeks) administration of intravenous colistin. BMC Infect Dis, 2005,5:1. doi: 10.1186/1471-2334-5-1. doi: 10.1186/1471-2334-5-1 URL
[29]	Lee HC, Chuang YC, Yu WL, et al. Clinical implications of hypermucoviscosity phenotype in Klebsiella pneumoniae isolates: association with invasive syndrome in patients with community-acquired bacteraemia. J Intern Med, 2006,259(6):606-614. doi: 10.1111/j.1365-2796.2006.01641.x. doi: 10.1111/j.1365-2796.2006.01641.x URL
[30]	Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J, 2020,56(1):2000535. doi: 10.1183/13993003.00535-2020. doi: 10.1183/13993003.00535-2020 URL

例号及文献编号	年龄 (岁)	性别	临床症状	基础疾病	诊断方法	治疗方法	药品使用时间	预后
例1^[7]	48	男	发热3个月,双下肢无力1周	艾滋病	脑脊液培养结果为非结核分枝杆菌	异烟肼、利福平、乙胺丁醇和吡嗪酰胺	12d	死亡
例2^[7]	27	男	干咳和发热症状达6个月,并出现进行性呼吸困难达10d	艾滋病	脑脊液培养结果为非结核分枝杆菌	利福平、乙胺丁醇、阿米卡星、阿奇霉素和莫西沙星	73d	死亡
例3^[8]	24	男	头痛加剧,意识混乱,体质量减轻数月	后颅窝肿瘤病史	脑脊液培养显示抗酸杆菌阳性,推测为非结核分枝杆菌	阿奇霉素、阿米卡星和头孢西丁	32d	死亡
例4^[9]	14	女	头痛和抽搐2个月	后颅窝神经胶质瘤伴双侧心室扩张	脑脊液染色可见抗酸杆菌();GeneXpert MTB/RIF阴性。鉴定结果为福特分枝杆菌	利奈唑胺、氧氟沙星、氯法齐明、克拉霉素	3个月	好转
例5^[10]	13	女	持续发热数月	脊柱裂	脑脊液中分离出福特分枝杆菌	阿米卡星(42d)、甲氧苄氨嘧啶-磺胺甲恶唑	7.5个月	好转
例6^[11]	13	女	发热、头痛、呕吐	急性B淋巴细胞白血病	脑脊液细菌培养结果为非结核分枝杆菌	异烟肼、利福平、吡嗪酰胺、莫西沙星	18个月	治愈
本例	46	女	畏寒发热	T细胞大颗粒淋巴细胞白血病	脑脊液二代基因测序结果为鸟分枝杆菌	莫西沙星(4个月)、克拉霉素(4个月)、利奈唑胺	11个月	治愈