臍帯血移植後の患者に胆嚢炎を合併した播種性結核．

Disseminated Tuberculosis with Cholecystitis in a Patient after Cord Blood Transplantation.

• Takaaki Konuma
• Masamichi Isobe
• Eisuke Adachi
• Seiko Kato
• Satoshi Takahashi
• Hiroshi Yotsuyanagi
• Arinobu Tojo

抄録

同種造血細胞移植後の活動性結核感染症の発症率は高い。本稿では，臍帯血移植（CBT）後に急性骨髄性白血病を発症した患者の症例を報告する。臍帯血移植後36日目に発熱を呈し，36日目のCT検査で胆嚢壁の軽度の肥厚を認めた．その後，喀痰検査と血液培養で結核菌の増殖が陽性であった。併用療法を2ヵ月間続けたところ，症状，胆嚢所見ともに改善した．以上のことから、CBTを受けた患者に急性胆嚢炎を合併した播種性結核を発症した1例を報告する。

The incidence of an active tuberculosis infection after allogeneic hematopoietic cell transplantation is high. We herein report the case of a patient with acute myeloid leukemia after cord blood transplantation (CBT). On day 36 after CBT, the patient developed fever, and a computed tomography scan on day 36 showed mild thickening of the wall of the gallbladder. Subsequently, a sputum specimen and a blood culture returned positive for the growth of Mycobacterium tuberculosis. After 2 months of administering combination therapy, both the symptoms and gallbladder findings improved. We therefore describe a case of disseminated tuberculosis with the gallbladder mimicking acute cholecystitis in a CBT recipient.