Department of Respiratory Medicine, NHO Tenryu Hospital, Hamamatsu, Japan
Department of Respiratory Medicine, NHO Tenryu Hospital, Hamamatsu, Japan.
BMJ Case Rep. 2023 Nov 16;16(11):e256007. doi: 10.1136/bcr-2023-256007.
A woman in her 70s with a history of nodular bronchiectatic complex pulmonary disease (MAC-PD) presented with an exacerbated productive cough and worsening findings on chest imaging. Although repeated sputum culture tests were negative for acid-fast bacilli and only revealed normal respiratory flora, a bronchoscopy identified sp. Consequently, she was diagnosed with pulmonary nocardiosis and was successfully treated with levofloxacin. It is known that pulmonary nocardiosis can manifest in immunocompetent individuals with bronchiectasis. For cases of refractory nodular bronchiectatic MAC-PD, it is vital to consider bronchoscopy to identify potential co-infections, such as .
一位 70 多岁的女性，患有结节性支气管扩张型复杂肺部疾病（MAC-PD），出现咳嗽加剧和胸部影像学检查结果恶化。尽管反复的痰培养检测均为抗酸杆菌阴性，仅显示正常的呼吸道菌群，但支气管镜检查发现了 。因此，她被诊断为肺部奴卡菌病，并成功地接受左氧氟沙星治疗。已知肺部奴卡菌病可发生在支气管扩张的免疫功能正常的个体中。对于难治性结节性支气管扩张型 MAC-PD 病例，重要的是要考虑支气管镜检查以识别潜在的合并感染，如 。
