Allergic Bronchopulmonary Aspergillosis with Repeated Isolation of Nontuberculous Mycobacteria
Autor: | Tsutomu Yanagisawa, Takashi Ishiguro, Yutaka Sugita, Yotaro Takaku, Noboru Takayanagi, Yoshihiko Shimizu, Yoshinori Kawabata, Naho Kagiyama |
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Rok vydání: | 2013 |
Předmět: |
Pathology
medicine.medical_specialty Itraconazole Mycobacterium Infections Nontuberculous Atelectasis Aspergillosis Diagnosis Differential Adrenal Cortex Hormones Internal Medicine medicine Thoracoscopy Humans Lung Aged Asthma medicine.diagnostic_test biology business.industry Aspergillosis Allergic Bronchopulmonary Sputum Nontuberculous Mycobacteria General Medicine bacterial infections and mycoses medicine.disease biology.organism_classification Treatment Outcome Female Nontuberculous mycobacteria Allergic bronchopulmonary aspergillosis medicine.symptom business medicine.drug |
Zdroj: | Internal Medicine. 52:1721-1726 |
ISSN: | 1349-7235 0918-2918 |
Popis: | A 68-year-old woman without asthma presented with a cough and abnormal shadows on a chest X-ray. Computed tomography showed right middle lobe atelectasis and centrilobular nodules with a tree-in-bud appearance in the other lobes. The patient's sputum repeatedly yielded positive cultures of nontuberculous mycobacteria (NTM); however, no fungi were detected. A transbronchial biopsy showed allergic mucin with eosinophils, although the findings were not diagnostic. We suspected that the patient had pulmonary mycobacteriosis; however, treatment for this condition failed. We then performed thoracoscopy for further evaluation and treatment of the NTM infection. The resected specimen obtained from the right middle lobe exhibited the characteristic findings of allergic bronchopulmonary mycosis without evidence of mycobacterial infection. The administration of corticosteroids and itraconazole resulted in improvement of the patient's condition. The NTM appeared to be simply a coincidental colonization of the resected middle lobe bronchus. The absence of asthma, the inability to isolate fungi and the repeated isolation of NTM made it difficult to differentiate allergic bronchopulmonary aspergillosis from NTM infection. |
Databáze: | OpenAIRE |
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