Hamada Kunio, Nagai Sonoko, Hara Yoshikazu, Hirai Toyohiro, Mishima Michiaki
Division of Internal Medicine, Chitose City Hospital, Chitose.
Intern Med. 2006;45(1):15-20. doi: 10.2169/internalmedicine.45.1217. Epub 2006 Feb 1.
A 67-year-old woman presented high-grade fever and dyspnea. Sputum culture confirmed Mycobacterium avium-intracellulare complex (MAC). Transbronchial lung biopsies revealed organizing pneumonia (OP) that was rapidly improved with corticosteroid. Five months after onset, a nodule emerged in the right lung. Although MAC was confirmed, the lesion was deemed too small to merit anti-mycobacterial chemotherapy. Four months later, diffuse infiltrates developed on chest X-ray. Bronchoalveolar lavage study identified MAC and exhibited OP patterns. We commenced antimycobacterial chemotherapy. The infiltrates almost completely improved within a month without corticosteroid.
一名67岁女性出现高热和呼吸困难。痰培养证实为鸟分枝杆菌-胞内分枝杆菌复合体（MAC）。经支气管肺活检显示为机化性肺炎（OP），使用皮质类固醇后病情迅速改善。发病五个月后，右肺出现一个结节。虽然确诊为MAC，但病变太小，不值得进行抗分枝杆菌化疗。四个月后，胸部X线显示出现弥漫性浸润。支气管肺泡灌洗研究发现MAC并呈现OP模式。我们开始进行抗分枝杆菌化疗。在未使用皮质类固醇的情况下，浸润在一个月内几乎完全改善。
