Matsuzawa Kuniaki, Tsukaguchi Katsuhiko, Okamura Hideo, Kasahara Reiko, Tamura Mouka, Kimura Hiroshi
Department of Internal Medicine, National Nishinara Hospital, 789 Shichijou-cho, Nara 630-8053, Japan.
Nihon Kokyuki Gakkai Zasshi. 2004 Jun;42(6):519-22.
We report a case of lung infection due to Mycobacterium abscessus (M. abscessus), complicated with primary macroamylasemia. A 76-year-old man was admitted to our hospital in August 2002 because of bloody sputum and an abnormal shadow found on chest radiography. The patient had had pulmonary tuberculosis from 1998 to 2000. He was found to be antacid bacillus-positive (Gaffky 5) on examination of the sputum in August 2002, but after hospitalization was negative for tuberculosis bacillus on sputum examination by the PCR method. We had suspected the presence of non-tuberculous mycobacterial disease since the patient's admission, and had started a regime of three drugs: clarithromycin, rifampicin, and ethambutol. The bacteria were identified as M. abscessus in a later sputum culture examination. It was noticed that the blood amylase level was high, and the disease was diagnosed as primary macroamylasemia. Such a case of lung infection due to M. abscessus complicated with macroamylasemia has rarely been reported in Japan.
我们报告一例因脓肿分枝杆菌(M. abscessus)引起的肺部感染,并伴有原发性巨淀粉酶血症。一名76岁男性于2002年8月因咯血痰及胸部X线检查发现异常阴影入住我院。该患者在1998年至2000年期间患有肺结核。2002年8月痰检发现抗酸杆菌阳性(加夫基5级),但住院后采用PCR法痰检结核杆菌呈阴性。自患者入院以来,我们一直怀疑存在非结核分枝杆菌病,并开始使用克拉霉素、利福平及乙胺丁醇三种药物治疗。后来的痰培养检查将细菌鉴定为脓肿分枝杆菌。注意到血淀粉酶水平升高,该病被诊断为原发性巨淀粉酶血症。在日本,这种因脓肿分枝杆菌引起的肺部感染并发巨淀粉酶血症的病例鲜有报道。