Ikegami Hiroaki, Yamasaki Kei, Kawanami Toshinori, Fukuda Kazumasa, Akata Kentaro, Nakamura Midori, Ikushima Issei, Fukuda Yoko, Noguchi Shingo, Yatera Kazuhiro
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
Department of Microbiology, University of Occupational and Environmental Health, Japan.
Intern Med. 2020 Jun 1;59(11):1417-1422. doi: 10.2169/internalmedicine.3540-19. Epub 2019 Dec 20.
A 67-year-old man with a pulmonary cavity was admitted to our hospital. Mycobacterial culture of the bronchoalveolar lavage fluid sample obtained from the right upper pulmonary lesion tested positive for mycobacterium, and sequencing of the 16S rRNA genes, hsp65, and rpoB revealed that the cultured mycobacterium was Mycobacterium parascrofulaceum. Treatment with antimycobacterial agents was ineffective, and repeated culturing of bronchoscopic specimens revealed that the specimens were positive for Aspergillus fumigatus. Combination treatment of antimycobacterial agents and voriconazole improved the lung lesion. This is the first report of a patient with pulmonary M. parascrofulaceum infection complicated with chronic progressive pulmonary aspergillosis.
一名患有肺空洞的67岁男性入住我院。从右上肺病变获取的支气管肺泡灌洗液样本的分枝杆菌培养显示分枝杆菌检测呈阳性,16S rRNA基因、hsp65和rpoB测序表明培养出的分枝杆菌为副结核分枝杆菌。抗分枝杆菌药物治疗无效,支气管镜标本反复培养显示标本烟曲霉呈阳性。抗分枝杆菌药物与伏立康唑联合治疗使肺部病变得到改善。这是首例副结核分枝杆菌肺部感染合并慢性进行性肺曲霉病患者的报告。