Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Non-tuberculous Mycobacterial Lung Disease Presenting as a Solitary Pulmonary Nodule

고립성 폐결절로 발현된 비결핵성 마이코박테리움 폐질환 1예

  • Kim, Song-Yee (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Kyung-Jong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-Kook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Byung-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Jung, Ji-Ye (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Son, Ji-Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Yoon, Yoe-Wun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Shim, Hyo-Sup (Department of Pathology, Yonsei University College of Medicine) ;
  • Kang, Young-Ae (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Moo-Suk (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young-Sam (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Se-Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Moon, Jin-Wook (Department of Internal Medicine, Yonsei University College of Medicine)
  • 김송이 (연세대학교 의과대학 내과학교실) ;
  • 이경종 (연세대학교 의과대학 내과학교실) ;
  • 이상훈 (연세대학교 의과대학 내과학교실) ;
  • 이상국 (연세대학교 의과대학 내과학교실) ;
  • 박병훈 (연세대학교 의과대학 내과학교실) ;
  • 정지예 (연세대학교 의과대학 내과학교실) ;
  • 손지영 (연세대학교 의과대학 내과학교실) ;
  • 윤여운 (연세대학교 의과대학 내과학교실) ;
  • 심효섭 (연세대학교 의과대학 병리학교실) ;
  • 강영애 (연세대학교 의과대학 내과학교실) ;
  • 박무석 (연세대학교 의과대학 내과학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실) ;
  • 장준 (연세대학교 의과대학 내과학교실) ;
  • 김세규 (연세대학교 의과대학 내과학교실) ;
  • 문진욱 (연세대학교 의과대학 내과학교실)
  • Received : 2010.02.03
  • Accepted : 2010.03.10
  • Published : 2010.07.30
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Abstract

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

Keywords

References

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