Successful Pulmonary Resection Combined with Chemotherapy for the Treatment of Mycobacterium avium Pulmonary Disease : A Case Report

내과적 치료와 함께 폐절제술을 시행하여 균음전에 성공한 Mycobacterium avium 폐질환 1례

  • Koh, Won-Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, O Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, Eun Hae (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Suh, Gee Young (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Man Pyo (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hojoong (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Kwhanmien (Division of Pulmonary and Critical Care Medicine, Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Nam Yong (Division of Pulmonary and Critical Care Medicine, Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Han, Joungho (Division of Pulmonary and Critical Care Medicine, Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Tae Sung (Division of Pulmonary and Critical Care Medicine, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Kyung Soo (Division of Pulmonary and Critical Care Medicine, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 고원중 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 권오정 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 강은해 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 서지영 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 정만표 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 김호중 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 김관민 (성균관대학교 의과대학 내과학교실 삼성서울병원 흉부외과) ;
  • 이남용 (성균관대학교 의과대학 내과학교실 삼성서울병원 진단검사의학과) ;
  • 한정호 (성균관대학교 의과대학 내과학교실 삼성서울병원 병리과) ;
  • 김태성 (성균관대학교 의과대학 내과학교실 삼성서울병원 방사선과) ;
  • 이경수 (성균관대학교 의과대학 내과학교실 삼성서울병원 방사선과)
  • Published : 2003.06.30

Abstract

The Mycobacterium avium complex (MAC) is the most common pathogen causing nontuberculous mycobacterial pulmonary disease. Despite the introduction of newer, more effective agents for the treatment of MAC, such as clarithromycin, the response to drug therapy in MAC pulmonary disease remains poor, and often frustrating. When MAC pulmonary disease has not been successfully eradicated using drug treatment alone, surgical management is still recognized to play a significant role. A case of MAC pulmonary disease, in a patient whose MAC disease was successfully treated by pulmonary resection, following the failure of drug therapy containing clarithromycin, is reported. To our knowledge, this is the first case report in Korea that the patient underwent a pulmonary resection for the treatment of MAC pulmonary disease.

MAC는 NTM 폐질환의 가장 흔한 원인균이다. Clarithromycin과 같은 새로운 항생제의 사용에도 불구하고, 아직까지 MAC 폐질환의 내과적 치료성적은 만족스럽지 않으며, 따라서 내과적 치료만으로 균음전에 성공하지 못하였을 때, 폐병변이 국한되어 있다면 폐절제술을 고려하여야 한다. 국내에서는 아직까지 MAC 폐질환의 치료를 위하여 폐절제술을 시행한 증례가 보고되지 않았다. 저자들은 MAC 폐질환을 진단하고 clarithromycin을 포함한 내과적 치료에 실패한 환자에서 폐절제술을 시행 후 균음전에 성공한 환자를 경험하여 이를 보고하는 바이다.

Keywords