Tabata Erina, Sekine Akimasa, Hagiwara Eri, Tajiri Michihiko, Ogura Takashi
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan.
Department of Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Center, Japan.
Intern Med. 2019 Apr 1;58(7):973-978. doi: 10.2169/internalmedicine.1370-18. Epub 2018 Nov 19.
We herein report three cases of refractory Mycobacterium avium complex (MAC) disease successfully treated surgically despite the MAC lesions being present bilaterally. Of note, although two patients did not present with any respiratory symptom, bronchoscopy clearly revealed a major excretory lesion with a large amount of purulent sputum in all patients. Because an excretory lesion was localized, surgical resection was performed, and the mycobacterial sputum smear became negative in all patients. Bronchoscopy may be a useful examination for detecting major excretory lesions with purulent sputum, which can disseminate to other lobes, and for determining the surgical indications of refractory MAC patients, regardless of the presence of respiratory symptoms.
我们在此报告三例难治性鸟分枝杆菌复合群（MAC）病，尽管MAC病变双侧存在，但通过手术成功治愈。值得注意的是，尽管两名患者未出现任何呼吸道症状，但支气管镜检查清楚地显示所有患者均有一个主要的排菌病变，并伴有大量脓性痰液。由于排菌病变局限，因此进行了手术切除，所有患者的分枝杆菌痰涂片均转为阴性。支气管镜检查对于检测可能扩散至其他肺叶的伴有脓性痰液的主要排菌病变以及确定难治性MAC患者的手术指征可能是一种有用的检查方法，无论患者是否有呼吸道症状。
