[Analysis of the clinical features of pulmonary disease caused by Mycobacterium szulgai].

SUBJECTS & METHODS: We reviewed the patient characteristics, radiological findings, treatments, and clinical outcomes in 12 cases of pulmonary Mycobacterium szulgai disease diagnosed at our hospital from April 1998 to March 2008. In addition, drug susceptibility testing of the causative isolates was performed with several antibiotics, including clarithromycin (CAM) and rifampicin (RFP), using BrothMIC NTM.

RESULTS

The patients included 10 men and 2 women, with a mean age of 57.2 years. Among them, 10 were smokers, 5 previously had pulmonary tuberculosis, 3 had a history of gastric ulcers, and 1 had a history of esophageal cancer surgery. All patients had been previously treated with various chemotherapeutic regimens. Six of them were treated with chemotherapy, including CAM, and they improved both radiologically and bacteriologically. The minimal inhibitory concentration of CAM for all the strains tested was less than 0.25 microg/mL, which is the likely critical concentration for clinical efficacy of CAM. The present study suggested that, in addition to smoking and a history of pulmonary tuberculosis, gastroesophageal disorders were relevant underlying conditions in patients with pulmonary M. szulgai disease.

CONCLUSION

Chemotherapeutic drugs, including CAM, are clinically and bacteriologically effective for pulmonary M. szulgai disease.