1.Surgical Treatment of Pulmonary Diseases Due to Nontuberculous Mycobacteria.
Won Jung KOH ; Yee Hyung KIM ; O Jung KWON ; Yong Soo CHOI ; Kwhanmien KIM ; Young Mog SHIM ; Jhingook KIM
Journal of Korean Medical Science 2008;23(3):397-401
Although the treatment of pulmonary diseases due to nontuberculous mycobacteria (NTM) requires the long-term use of antibiotics in combination, the treatment success rates are unsatisfactory. We evaluated the clinical characteristics and surgical outcomes of 23 patients with NTM lung diseases who had underwent pulmonary resection. The median age of the patients was 45 yr. Of the 23 patients, 10 had Mycobacterium avium-intracellulare complex infection, 12 had M. abscessus infection, and one had M. xenopi infection. The indications for surgery were antibiotic therapy failure (n=11), remnant cavitary lesion with high probability of relapse (n=8), and massive hemoptysis (n=4). The most common procedure was lobectomy (48%). Postoperative complications occurred in eight patients (35%), including postoperative pneumonia (n=3) and late bronchopleural fistula (n=2). Negative sputum culture conversion was achieved and maintained in all except two mortalities. Although it is associated with a relatively high complication rate, patients with NTM lung disease whose disease is localized to one lung and who can tolerate resectional surgery might be considered for surgery, if there has been poor response to drug therapy or if the patients develop significant disease-related complications such as hemoptysis.
Adult
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Antitubercular Agents/therapeutic use
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Drug Resistance, Bacterial
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Female
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Hemoptysis/microbiology/surgery
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Humans
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Male
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Middle Aged
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Mycobacterium Infections, Atypical/drug therapy/*surgery
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*Mycobacterium avium Complex
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Mycobacterium avium-intracellulare Infection/drug therapy/*surgery
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*Mycobacterium xenopi
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Postoperative Complications
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Retrospective Studies
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Treatment Outcome
2.Mycobacterium Avium Complex Infection Presenting as an Endobronchial Mass in a Patient with Acquired Immune Deficiency Syndrome.
Ho Cheol KIM ; In Gyu BAE ; Jeong Eun MA ; Jong Shil LEE ; Kyoung Nyeo JEON ; Jong Deok LEE ; Young Sil HWANG
The Korean Journal of Internal Medicine 2007;22(3):215-219
Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with AIDS (acquired immune deficiency syndrome). Pulmonary involvement of MAC may range from asymptomatic colonization of the respiratory tract to invasive parenchymal or cavitary disease. However, endobronchial lesions with MAC infection are rare in immunocompetent and immunosuppressed hosts. Here, we report MAC infection presenting as an endobronchial mass in a patient with AIDS.
Acquired Immunodeficiency Syndrome/*complications
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Adult
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Antitubercular Agents/therapeutic use
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Bronchial Diseases/complications/diagnosis/drug therapy/*microbiology
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Bronchoscopy
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Humans
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Male
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Mycobacterium avium Complex
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Mycobacterium avium-intracellulare Infection/complications/*diagnosis/drug therapy
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Opportunistic Infections/*complications/diagnosis/drug therapy
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Tomography, X-Ray Computed
3.Mycobacterium Avium Arthritis with Extra-articular Abscess in a Patient with Mixed Connective Tissue Disease.
Choong Won LEE ; Han Dong SUNG ; Byong Moon CHOI ; Chun Wook KIM ; Su Jin JUN ; Sang Jo MIN
The Korean Journal of Internal Medicine 2003;18(2):119-121
A case of Mycobacterium avium arthritis in a 39-year-old female patient with mixed connective tissue disease (MCTD) was reported. An extra-articular abscess had formed outside the knee joint and extended down the calf. A culture was taken of the abscess and synovial fluid disclosed Mycobacteriun avium. This was resistant to most anti-tuberculosis agents. A combination of anti-tuberculosis drugs followed a total resection of the abscess. We concluded that M avium septic arthritis could insidiously develop into an extra-articular abscess. A combination of anti-tuberculosis drugs with a total resection of the abscess was an effective treatment.
Adult
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Antitubercular Agents/therapeutic use
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Arthritis, Infectious/*microbiology/therapy
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Female
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Human
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Knee Joint/*microbiology/surgery
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Mixed Connective Tissue Disease/*complications
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Mycobacterium avium/drug effects/*isolation & purification
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Mycobacterium avium-intracellulare Infection/*complications/therapy
4.Mycobacterium avium lung disease combined with a bronchogenic cyst in an immunocompetent young adult.
Yong Soo KWON ; Joungho HAN ; Ki Hwan JUNG ; Je Hyeong KIM ; Won Jung KOH
The Korean Journal of Internal Medicine 2013;28(1):94-97
We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin.
Anti-Bacterial Agents/therapeutic use
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Biopsy
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Bronchogenic Cyst/*complications/diagnosis/immunology/surgery
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Humans
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*Immunocompetence
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Male
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Mycobacterium avium Complex/*isolation & purification
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Mycobacterium avium-intracellulare Infection/*complications/diagnosis/drug therapy/immunology/microbiology
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Pneumonectomy
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Respiratory Tract Infections/*complications/diagnosis/drug therapy/immunology/microbiology
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Sputum/microbiology
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Tomography, X-Ray Computed
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Treatment Outcome
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Young Adult