1.Diagnosis and Treatment of Nontuberculous Mycobacterial Pulmonary Diseases: A Korean Perspective.
Won Jung KOH ; O Jung KWON ; Kyung Soo LEE
Journal of Korean Medical Science 2005;20(6):913-925
The incidence of pulmonary disease caused by nontuberculous mycobacteria (NTM) appears to be increasing worldwide. In Korea, M. avium complex and M. abscessus account for most of the pathogens encountered, whilst M. kansasii is a relatively uncommon cause of NTM pulmonary diseases. NTM pulmonary disease is highly complex in terms of its clinical presentation and management. Because its clinical features are indistinguishable from those of pulmonary tuberculosis and NTMs are ubiquitous in the environment, the isolation and identification of causative organisms are mandatory for diagnosis, and some specific diagnostic criteria have been proposed. The treatment of NTM pulmonary disease depends on the infecting species, but decisions concerning the institution of treatment are never easy. Treatment requires the use of multiple drugs for 18 to 24 months. Thus, treatment is expensive, often has significant side effects, and is frequently not curative. Therefore, clinicians should be confident that there is sufficient pathology to warrant prolonged, multidrug treatment regimens. In all of the situations, outcomes can be best optimized only when clinicians, radiologists, and laboratories work cooperatively.
Anti-Bacterial Agents/therapeutic use
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Female
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Humans
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Korea
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Lung Diseases/*diagnosis/drug therapy/microbiology
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Male
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Mycobacterium Infections, Atypical/*diagnosis/drug therapy/microbiology
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Mycobacterium avium-intracellulare Infection/diagnosis/drug therapy/microbiology
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Research Support, Non-U.S. Gov't
2.Mycobacterium kansasii Pulmonary Diseases in Korea.
Jae Joon YIM ; Young Kil PARK ; Woo Jin LEW ; Gill Han BAI ; Sung Koo HAN ; Young Soo SHIM
Journal of Korean Medical Science 2005;20(6):957-960
Mycobacterium kansasii is one of the most common cause of pulmonary diseases due to nontuberculous mycobacteria. We investigated the changing in the number of isolation of M. kansasii and the clinical characteristics of M. kansasii pulmonary disease in Korea. Through searching the database of the Korean Institute of Tuberculosis, we identified the cases of isolated M. kansasii from 1992 to 2002. The number of M. kansasii isolation had increased from once in 1992 to 62 in 2002. Fifteen patients with M. kansasii pulmonary disease were identified during the period January 1997 to December 2002. Twelve patients (80%) were male and fourteen (93%) were from highly industrialized areas. The most common symptom was a cough. Seven patients (47%) had a cavitary lesion and right upper lobe was most commonly involved. Patients responded well to isoniazid and rifampicin based regimens both bacteriologically and radiographically. In conclusion, M. kansasii isolation has increased, especially in highly industrialized areas, as well as other nontuberculous mycobacteria in Korea.
Adult
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Aged
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Anti-Bacterial Agents/therapeutic use
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Female
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Humans
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Korea/epidemiology
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Lung Diseases/diagnosis/drug therapy/*epidemiology/microbiology
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Male
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Middle Aged
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Mycobacterium Infections, Atypical/diagnosis/drug therapy/*epidemiology/microbiology
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*Mycobacterium kansasii/isolation and purification
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Research Support, Non-U.S. Gov't