Sakakibara Yumi, Kishimoto Kumiko, Kojima Kaoru, Fujie Toshihide, Inase Naohiko
Kekkaku. 2014 Apr;89(4):509-13.
An 85-year-old man with dementia first visited our hospital 5 years ago, complaining of hemoptysis. He was hospitalized 2 years later owing to fever, cough, and dyspnea. A chest computed tomography scan showed infiltration with a cavity in the left upper lobe. He was diagnosed with nontuberculous mycobacterial lung infection on the basis of the presence of acid-fast bacilli in the sputum and repeated bronchoalveolar lavage specimens; however, we were unable to identify the isolate by DNA-DNA hybridization. Although his general condition had slightly improved after treatment initiation, intermittent chemotherapy owing to the adverse effects of the drugs and dementia led to rapid disease progression and death. After his death, the isolated mycobacterium was identified as Mycobacterium kyorinense by sequence analysis of the hsp 65 and rpoB genes.
一名85岁的痴呆症男性患者于5年前首次前来我院就诊，主诉咯血。2年后，他因发热、咳嗽和呼吸困难入院。胸部计算机断层扫描显示左上叶有浸润伴空洞形成。根据痰及反复支气管肺泡灌洗标本中存在抗酸杆菌，他被诊断为非结核分枝杆菌肺部感染；然而，我们无法通过DNA-DNA杂交鉴定出该分离株。尽管开始治疗后他的一般状况略有改善，但由于药物不良反应和痴呆导致的间歇性化疗使疾病迅速进展并导致死亡。他死后，通过对hsp 65和rpoB基因进行序列分析，鉴定出分离出的分枝杆菌为京都分枝杆菌。
