Kanno Kiyoshi, Akai Masaya, Kato Tomohiro, Tada Toshihiko, Watanabe Kizuku, Shiozaki Kouhei, Hase Mitsuo
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, 2-4-1, Tsukimi, Fukui-shi, Fukui 918-8501, Japan.
Kekkaku. 2012 May;87(5):403-7.
We report here a case of hypersensitivity pneumonitis-like disease in an adult, likely due to exposure to Mycobacterium avium complex (MAC) in his bathtub water at home. A 63-year-old man was referred to our hospital with exertional dyspnea. Chest computed tomography showed bilateral, diffuse, centrilobular ground-glass nodules. Bronchoalveolar lavage showed marked lymphocytosis. Transbronchial biopsy showed epithelioid cell granulomas and lymphocyte alveolitis. Cultures of the patient's sputum and bathtub water yielded MAC. Variable-number tandem repeat analysis of the MAC strains in the sputum and bathtub water samples showed that the strains were genetically identical. The clinical condition of the patient improved at home under chemotherapy by avoiding the use of the bathtub.
我们在此报告一例成人超敏性肺炎样疾病,可能是由于在家中浴缸水中接触鸟分枝杆菌复合群(MAC)所致。一名63岁男性因劳力性呼吸困难转诊至我院。胸部计算机断层扫描显示双侧弥漫性小叶中心性磨玻璃结节。支气管肺泡灌洗显示明显的淋巴细胞增多。经支气管活检显示上皮样细胞肉芽肿和淋巴细胞性肺泡炎。患者痰液和浴缸水培养均检出MAC。对痰液和浴缸水样本中的MAC菌株进行可变数目串联重复分析显示,这些菌株在基因上是相同的。患者在家中接受化疗并避免使用浴缸后,临床状况有所改善。