Solitary Pulmonary Nodule due to Mycobacterium intracellulare: The First Case in Korea.
10.3349/ymj.2007.48.1.127
- Author:
Yong Soo KWON
1
;
Won Jung KOH
;
Man Pyo CHUNG
;
O Jung KWON
;
Nam Yong LEE
;
Eun Yoon CHO
;
Joung Ho HAN
;
Tae Sung KIM
;
Kyung Soo LEE
;
Byung Tae KIM
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wjkoh@smc.samsung.co.kr
- Publication Type:Case Report
- Keywords:
Pulmonary coin lesion;
atypical mycobacteria;
Mycobacterium avium complex;
tuberculosis;
tuberculoma
- From:Yonsei Medical Journal
2007;48(1):127-130
- CountryRepublic of Korea
- Language:English
-
Abstract:
Here, we describe a case of a solitary pulmonary nodule due to Mycobacterium intracellulare infection. To the best of our knowledge, this is the first case reported in Korea. A 45-year- old female, exhibiting no respiratory symptoms, was admitted to our hospital due to the appearance of a solitary pulmonary nodule on a chest radiograph. Computed tomography revealed a 2.5 cm nodule with an irregular shape and some marginal spiculation in the right upper lobe. Positron emission tomography with fluorodeoxyglucose imaging revealed positive tumor uptake (maximum standardized uptake value=8.8). Bronchoscopy yielded no specific histological findings and no bacteriological findings. Percutaneous transthoracic lung biopsy revealed epithelioid granuloma but no acid-fast bacilli were detected. The patient received isoniazid, rifampin, ethambutol, and pyrazinamide for the treatment of "tuberculoma". Five weeks after the patient was admitted, numerous mycobacterial colonies were detected on a bronchial washing fluid culture. These colonies were subsequently identified as Mycobacterium intracellulare. A final diagnosis of M. intracellulare pulmonary disease was made, and the patient's treatment regimen was changed to a combination therapy consisting of clarithromycin, rifampin, and ethambutol.
