Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies...Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies. The clinical effect was a complete response. Chest CT was performed because of continuous dry cough, and a new tumor shadow was recognized in the lingula portion of the left upper lobe. We performed CT-guided lung biopsy and could aspirate pus-fluid. The culture test for acid-fast bacilli was positive and the causative microorganism was identified as Mycobacterium avium by the DDH method. The final diagnosis was pulmonary abscess due to M. avium. Treatment using combined chemotherapy including CAM was performed and a good clinical response was obtained. Case 2 was a 67-year-old man who had a past history of surgical resection of lung adenocarcinoma eight and two years ago and received several cancer chemotherapies and radiation therapy. Because a new nodular shadow appeared in the right middle lobe one year ago and showed strong positivity on PET/CT, surgical resection was performed with the suspected recurrence of lung cancer. Subsequently, the histological diagnosis was epithelioid granuloma and a culture test of acid-fast bacilli was positive, with the identification of Mycobacterium intracellulare by the DDH method. Combined chemotherapy was not performed because the lesion was completely resected. Afterwards, a new nodular shadow appeared in the left lower lobe again and bronchoscopy was performed. Because M. intracellulare was isolated from the local specimen, we diagnosed the patient with recurrence of pulmonary MAC disease and combined chemotherapy including CAM was performed for one year. Finally, the nodular lesion disappeared. It is difficult to differentiate pulmonary MAC disease from lung cancer. Therefore, careful follow-up of patients with lung cancer while keeping in mind the possible complication of pulmonary MAC disease is necessary.展开更多
We recently encountered two patients with pulmonary Mycobacterium kansasii disease showing a solitary nodule. The patients were 53 and 66 years old and both were male. One patient had underlying diseases. The diagnosi...We recently encountered two patients with pulmonary Mycobacterium kansasii disease showing a solitary nodule. The patients were 53 and 66 years old and both were male. One patient had underlying diseases. The diagnosis was based on the clinical symptom in one patient and an abnormal chest shadow in the other. The final diagnosis was obtained by bronchoscopy and CT-guided lung biopsy. Antituberculous drugs were administered to one patient. We emphasize the importance of the positive identification of causative microorganisms in patients who present with a solitary nodule including surgical methods to differentiate the infection from lung cancer.展开更多
Non-tuberculous mycobacteria are a significant cause of pulmonary infections worldwide and can be clinically challenging.Mycobacterium xenopi(M.xenopi)has a low pathogenicity and usually requires immunosuppression or ...Non-tuberculous mycobacteria are a significant cause of pulmonary infections worldwide and can be clinically challenging.Mycobacterium xenopi(M.xenopi)has a low pathogenicity and usually requires immunosuppression or lung diseases.We describe herein a scarce case of pulmonary cavitary disease attributed to M.xenopi in a 57-year-old Caucasian patient with underlying structural lung disease successfully treated with rifampicin,ethambutol,clarithromycin,and amikacin.展开更多
目的探讨实时荧光核酸恒温扩增检测技术（simultaneous amplification and testing，SAT）用于疑似肺结核早期诊断的临床意义。方法分析2015年7-12月广州市胸科医院收治的呼吸道疾病患者338例，其中疑似肺结核患者242例（疑似肺结核组...目的探讨实时荧光核酸恒温扩增检测技术（simultaneous amplification and testing，SAT）用于疑似肺结核早期诊断的临床意义。方法分析2015年7-12月广州市胸科医院收治的呼吸道疾病患者338例，其中疑似肺结核患者242例（疑似肺结核组），临床已排除肺结核的肺部其他疾病患者96例（对照组）。所有患者同时进行了痰SAT检测、抗酸杆菌涂片、分枝杆菌培养和菌种鉴定等检查；统计疑似肺结核患者菌种鉴定结果，对SAT检测与结核分枝杆菌（MTB）培养及菌种鉴定结果的符合率、SAT检测诊断疑似肺结核的敏感度和特异度进行分析。结果疑似肺结核组242例患者中痰培养阳性233例，菌种鉴定为MTB感染者222例，非结核分枝杆菌（NTM）感染者11例；痰培养结果为阴性的患者9例。对照组患者痰培养结果均为阴性。菌种鉴定为MTB感染者SAT检测阳性192例，SAT检测与菌种鉴定符合率为86．5％（192／222）；菌种鉴定为NTM感染者SAT检测阳性0例（0／11），与菌种鉴定符合率为100．0％（11／11）；对照组SAT检测阳性者2例（2．1％，2／96），与分枝杆菌培养符合率为97．9％（94／96）。SAT在疑似肺结核患者诊断中的敏感度为86．5％（192／222），特异度为97．9％（94／96）。结论在疑似肺结核患者中开展SAT检测对肺结核早期诊断具有重要临床意义。展开更多
文摘Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies. The clinical effect was a complete response. Chest CT was performed because of continuous dry cough, and a new tumor shadow was recognized in the lingula portion of the left upper lobe. We performed CT-guided lung biopsy and could aspirate pus-fluid. The culture test for acid-fast bacilli was positive and the causative microorganism was identified as Mycobacterium avium by the DDH method. The final diagnosis was pulmonary abscess due to M. avium. Treatment using combined chemotherapy including CAM was performed and a good clinical response was obtained. Case 2 was a 67-year-old man who had a past history of surgical resection of lung adenocarcinoma eight and two years ago and received several cancer chemotherapies and radiation therapy. Because a new nodular shadow appeared in the right middle lobe one year ago and showed strong positivity on PET/CT, surgical resection was performed with the suspected recurrence of lung cancer. Subsequently, the histological diagnosis was epithelioid granuloma and a culture test of acid-fast bacilli was positive, with the identification of Mycobacterium intracellulare by the DDH method. Combined chemotherapy was not performed because the lesion was completely resected. Afterwards, a new nodular shadow appeared in the left lower lobe again and bronchoscopy was performed. Because M. intracellulare was isolated from the local specimen, we diagnosed the patient with recurrence of pulmonary MAC disease and combined chemotherapy including CAM was performed for one year. Finally, the nodular lesion disappeared. It is difficult to differentiate pulmonary MAC disease from lung cancer. Therefore, careful follow-up of patients with lung cancer while keeping in mind the possible complication of pulmonary MAC disease is necessary.
文摘We recently encountered two patients with pulmonary Mycobacterium kansasii disease showing a solitary nodule. The patients were 53 and 66 years old and both were male. One patient had underlying diseases. The diagnosis was based on the clinical symptom in one patient and an abnormal chest shadow in the other. The final diagnosis was obtained by bronchoscopy and CT-guided lung biopsy. Antituberculous drugs were administered to one patient. We emphasize the importance of the positive identification of causative microorganisms in patients who present with a solitary nodule including surgical methods to differentiate the infection from lung cancer.
文摘Non-tuberculous mycobacteria are a significant cause of pulmonary infections worldwide and can be clinically challenging.Mycobacterium xenopi(M.xenopi)has a low pathogenicity and usually requires immunosuppression or lung diseases.We describe herein a scarce case of pulmonary cavitary disease attributed to M.xenopi in a 57-year-old Caucasian patient with underlying structural lung disease successfully treated with rifampicin,ethambutol,clarithromycin,and amikacin.
文摘目的探讨实时荧光核酸恒温扩增检测技术（simultaneous amplification and testing，SAT）用于疑似肺结核早期诊断的临床意义。方法分析2015年7-12月广州市胸科医院收治的呼吸道疾病患者338例，其中疑似肺结核患者242例（疑似肺结核组），临床已排除肺结核的肺部其他疾病患者96例（对照组）。所有患者同时进行了痰SAT检测、抗酸杆菌涂片、分枝杆菌培养和菌种鉴定等检查；统计疑似肺结核患者菌种鉴定结果，对SAT检测与结核分枝杆菌（MTB）培养及菌种鉴定结果的符合率、SAT检测诊断疑似肺结核的敏感度和特异度进行分析。结果疑似肺结核组242例患者中痰培养阳性233例，菌种鉴定为MTB感染者222例，非结核分枝杆菌（NTM）感染者11例；痰培养结果为阴性的患者9例。对照组患者痰培养结果均为阴性。菌种鉴定为MTB感染者SAT检测阳性192例，SAT检测与菌种鉴定符合率为86．5％（192／222）；菌种鉴定为NTM感染者SAT检测阳性0例（0／11），与菌种鉴定符合率为100．0％（11／11）；对照组SAT检测阳性者2例（2．1％，2／96），与分枝杆菌培养符合率为97．9％（94／96）。SAT在疑似肺结核患者诊断中的敏感度为86．5％（192／222），特异度为97．9％（94／96）。结论在疑似肺结核患者中开展SAT检测对肺结核早期诊断具有重要临床意义。
