Fernandes Ana Luisa, Ferro Ana, Santos Joana Dos, Seabra Bárbara
Pulmonology Department, Hospital Pedro Hispano, Matosinhos, Portugal
Internal Medicine Department, Hospital Pedro Hispano, Matosinhos, Portugal.
BMJ Case Rep. 2021 Mar 5;14(3):e241737. doi: 10.1136/bcr-2021-241737.
Non-tuberculous mycobacterial pulmonary disease may have different clinical manifestations. We report a case of a 64-year-old woman presenting with persistent respiratory complaints, fever and radiological findings. Initially, she was diagnosed with community-acquired pneumonia, but after being submitted to an extensive investigation, including CT-guided transthoracic lung biopsy, a diagnosis of organising pneumonia (OP) was established. The patient was treated with corticosteroids with no favourable response. Subsequently, complex (MAC) was identified in bronchoalveolar lavage culture. The patient was diagnosed with OP secondary to MAC infection and specific antibiotic treatment was initiated. This case represents an infrequent association and illustrates how important it is to investigate primary causes of OP to obtain a satisfactory treatment response.
非结核分枝杆菌肺病可能有不同的临床表现。我们报告一例64岁女性病例，该患者有持续的呼吸道症状、发热及影像学表现。最初，她被诊断为社区获得性肺炎，但在接受包括CT引导下经胸肺活检在内的广泛检查后，确诊为机化性肺炎（OP）。患者接受皮质类固醇治疗，但效果不佳。随后，在支气管肺泡灌洗培养中发现了鸟分枝杆菌复合体（MAC）。该患者被诊断为MAC感染继发的OP，并开始了针对性抗生素治疗。该病例代表了一种罕见的关联，说明了调查OP的主要病因以获得满意治疗效果的重要性。
