Yoshimura Kotaro, Imao Motohiro, Goto Hideko, Nagase Seisuke, Komaki Chihito, Sano Kimiyasu, Kato Tatsuo
First Department of Internal Medicine, Gifu University School of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2005 Jan;43(1):32-6.
A 61-year-old woman presented to our hospital with a chronic cough. She had been diagnosed with pulmonary infection due to non-tuberculous mycobacteria by her previous doctor and had received antimycobacterial chemotherapy for 1 year. Chest radiography and computed tomography on the first visit to our hospital revealed nodular shadows with a cavity in the right upper lung field and infiltrative shadows with bronchiectasis in the lingular segment. Mycobacterium simiae was identified using DNA hybridization methods. Analysis of base sequences from sputum samples using 16S rRNA confirmed the identity of all tested isolates as Mycobacterium simiae, and the organism was isolated repeatedly from sputum mycobacterial tests. Pulmonary infection due to Mycobacterium simiae was diagnosed. Rifampicin, Ethambutol and Clarithromycin were administered to the patient, but clinical symptoms have continued, and findings on chest radiography have deteriorated. Cases of pulmonary infection due to Mycobacterium simiae are rare, and this represents the first such case reported in Japan.
一名61岁女性因慢性咳嗽前来我院就诊。她曾被前一位医生诊断为非结核分枝杆菌引起的肺部感染,并接受了抗分枝杆菌化疗1年。我院初诊时的胸部X线和计算机断层扫描显示右上肺野有结节状阴影伴空洞,舌段有浸润性阴影伴支气管扩张。使用DNA杂交方法鉴定出猿分枝杆菌。通过对痰液样本的16S rRNA碱基序列分析,证实所有检测分离株均为猿分枝杆菌,且该菌在痰液分枝杆菌检测中反复分离得到。诊断为猿分枝杆菌引起的肺部感染。给予患者利福平、乙胺丁醇和克拉霉素治疗,但临床症状持续存在,胸部X线检查结果恶化。猿分枝杆菌引起的肺部感染病例罕见,这是日本报道的首例此类病例。