Abstract：
A 65-year-old Japanese woman repeatedly withdrew and resumed antibiotics against pulmonary non-tuberculous mycobacterial infection caused by Mycobacterium intracellulare for more than 10 years. Although she continued to take medications, her respiratory symptoms and chest computed tomography indicated an enlarged infiltrative shadow in the lingular segment of the left lung that gradually worsened over the course of a year or more. Bronchoscopy was performed and mycobacterial culture of the bronchial lavage fluid was negative, whereas Exophiala dermatitidis was detected. After administration of oral voriconazole was initiated, the productive cough and infiltrative shadow resolved. There are no characteristic physical or imaging findings of E. dermatitidis, and it often mimics other chronic respiratory infections. Thus, when confronting refractory non-tuberculous mycobacterial cases, it might be better to assume other pathogenic microorganisms, including E. dermatitidis, and actively perform bronchoscopy.
摘要：
一名65岁的日本妇女反复撤回并恢复抗生素，以对抗由胞内分枝杆菌引起的肺部非结核分枝杆菌感染超过10年。尽管她继续服用药物，她的呼吸道症状和胸部计算机断层扫描显示，左肺舌段的浸润阴影增大，并在一年或更长时间内逐渐恶化。行支气管镜检查，支气管灌洗液分枝杆菌培养阴性，而检测到了皮肤Exophiala。开始口服伏立康唑后，生产性咳嗽和浸润性阴影解决。没有皮肤大肠杆菌的特征性物理或影像学发现，它经常模仿其他慢性呼吸道感染。因此，当面对难治性非结核分枝杆菌病例时，假设其他病原微生物可能更好，包括E.dermatitidis,并积极进行支气管镜检查。
