结核病 (TB) 是造血干细胞移植 (HSCT) 受者中一种罕见但具有潜在破坏性的并发症。血液系统恶性肿瘤患者，特别是接受骨髓移植和骨髓抑制治疗的患者应谨慎使用骨髓抑制相关抗生素。尽管利奈唑胺已成为重症结核病的推荐药物，但其血液学毒性仍是其临床应用的障碍。康泰唑胺是临床开发中的恶唑烷酮类新代表，显示出优越的抗感染功效，但目前尚未见治疗HSCT后结核病的报道。我们报道一例急性淋巴细胞白血病患者HSCT后出现肺部结核感染。抗结核治疗期间，患者对利奈唑胺方案反应不佳，出现牙龈出血、血小板减少等副作用，故改用康泰唑胺。连续治疗15天后，患者血小板升至58×109/L，病情稳定出院。随后7个多月的康泰唑胺抗结核治疗过程中，血小板保持稳定，未出现血液学不良反应，未出现周围神经病变症状。此外，重复影像学检查显示，双侧肺部病灶明显减少，表明患者预后良好。这是HSCT后结核病患者首次采用含康泰唑胺的抗生素管理策略成功治疗的病例，疗效显着，安全性良好在这种致命的疾病中。版权所有 © 2023 Li、Yu、Jiang、Lao 和 Li。

Tuberculosis (TB) is a rare but potentially devastating complication in hematopoietic stem cell transplantation (HSCT) recipients. Myelosuppression-related antibiotics should be used cautiously in patients with hematological malignancies, especially those undergoing bone marrow transplantation and receiving bone marrow suppression therapy. Although linezolid has become the recommended drug for severe TB, its hematological toxicity is still an obstacle to its clinical application. Contezolid is a new representative of oxazolidinones in clinical development, showing superior anti-infection efficacy, but there have been no reports on the treatment of post-HSCT TB.We reported a patient with acute lymphoblastic leukemia suffered from pulmonary TB infection after HSCT. During anti-TB treatment, the patient had a poor response to linezolid-containing regimen, and developed side effects such as gingival bleeding and thrombocytopenia, so the administration was switched to contezolid. After 15 days of continuous treatment, the patient's platelet increased to 58×109/L, and he was discharged in stable condition. During subsequent anti-TB treatment with contezolid for more than 7 months, the platelets remained stable, and no hematological adverse reactions and no symptoms of peripheral neuropathy were observed. Moreover, repeat imaging showed that the bilateral lung lesions were significantly reduced, indicating a good outcome for the patient.This was the first successful case of post-HSCT TB patients treated with contezolid-containing antibiotic management strategies, which exhibited remarkable efficacy and good safety in this deadly disease.Copyright © 2023 Li, Yu, Jiang, Lao and Li.