脓肿分枝杆菌性皮肤溃疡

报告1例院外散发的皮肤脓肿分枝杆菌病，患者女，52岁，左颞部慢性皮肤溃疡3年，常规细菌学和真菌学检查阴性，多种抗生素（包括异烟肼和利福平）治疗无效，皮损分枝杆菌培养及菌株鉴定为脓肿分枝杆菌，该分离株对异烟肼，利福平，乙胺丁醇耐药，对链霉素临界耐药。给予阿米卡星，克拉霉素及左旋氧氟沙星治疗后明显好转，提示在我国有院外散发脓肿分枝杆菌感染的病例，临床医生应提高对本病的认识，对可疑病例做非结核分枝杆菌培养和鉴定。

Chronic cutaneous ulcer caused by Mycobacterium abscessus

We reported a case of skin infection with Mycobacterium abscessus. A 52-year-old female presented for chronic progressive necrotic skin ulcer for 3 years. The lesion failed to respond to routine antibiotic therapy. Mycobacterium abscessus was isolated from the lesion. The Mycobacterium was resistant to isoniazid, rifampicin and ethambutol and intermediately susceptible to streptomycin. Clarithromycin, amikacin and L-ofloxacin were used and the lesion was improved. The key points to avoid misdiagnosis are earlier recognition of the disease and identification of Mycobacterium in suspected patients.