• 대한영상의학회지
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• 제82권4호
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• pp.838-850
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• 2021

비결핵마이코박테륨(nontuberculous mycobacterium; 이하 NTM) 폐질환은 우리나라를 포함하여 전 세계적으로 발생률과 유병률이 증가하고 있다. 더불어 NTM 폐질환의 임상적 중요성도 빠르게 증가하고 있으나, NTM 폐질환은 진단과 치료가 어려운 질환이다. NTM 폐질환의 진단을 위해서는 영상의학적 근거가 필수이며, 많은 환자에서 영상의학 소견은 NTM 폐질환을 진단하는 첫 번째 근거가 될 수 있다. NTM 폐질환의 영상의학 소견은 일반적으로 섬유공동병변형과 결절기관지확장형의 두 가지 형태로 구분하나, NTM 폐질환은 다양하고 비특이적인 영상의학 소견을 보일 수 있다. 영상의학과 의사는 영상의학 소견에 따라 NTM 폐질환의 가능성을 감별진단에 포함하여야 한다. 본 종설은 영상의학과 의사를 위한 NTM 폐질환의 국내 역학, 진단기준, 영상의학 소견을 중심으로 검토하였다.

• 대한한방내과학회지
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• 제41권5호
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• pp.856-867
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• 2020

Objectives: The purpose of this case study was to report the effect of Korean Medicine treatment on a patient diagnosed with nontuberculous mycobacterial lung disease. Methods: A 61-year-old female patient with nontuberculous mycobacterial lung disease was admitted to the clinic from October 15th, 2018 to November 7th, 2018. The patient was treated using Korean medical treatments of Jinhae-tang-gami, Ssanghwa-tang-gami, Haeyeol-tang, Jinhae-tang plus Ssanghwa-tang-gami, and Jinhae-tang plus Bojungikgi-tang-gami. We evaluated the improvement of symptoms by a numeric rating scale (NRS) score, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and body temperature. Results: After Korean medicine treatment, the patient's cough and sputum amounts were decreased as measured by the NRS score. CRP levels and ESR were also decreased and fever was relieved. Conclusion: This study suggested that Korean medicine treatment might be effective in treating patients diagnosed with nontuberculous mycobacterial lung disease.

• Tuberculosis and Respiratory Diseases
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• 제74권6호
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• pp.251-255
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• 2013

Tuberculosis (TB) is one of the largest health problems in the world today. And the incidence of nontuberculous mycobacteria (NTM) lung disease appears to be increasing worldwide. Recently, an automated, nucleic acid amplification assay for the rapid detection of both Mycobacterium tuberculosis and rifampin resistance was developed (Xpert MTB/RIF). And fixed-dose combinations of anti-TB drugs and linezolid have been introduced in the treatment of TB. And new NTM species, named Mycobacterium massiliense, which is very closely related to Mycobacterium abscessus was reported. In this review, these recent advances in the diagnosis and treatment of TB and clinical characteristics of M. massiliense lung disease are discussed.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.173-176
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• 2012

We report a rare case of lung disease caused by Mycobacterium terrae in a previously healthy woman. A 45-year-old woman was referred to our hospital due to a chronic cough with sputum. A computed tomography scan of the chest revealed bronchiolitis in conjuction with bronchiectasis in both lungs. Nontuberculous mycobacteria were identified and isolated from the bronchoalveolar lavage fluid collected from each lung. All isolates were identified as M. terrae by various molecular methods that characterized the rpoB and hsp65 gene sequences. Antibiotic therapy using clarithromycin, rifampin, and ethambutol improved the patient's condition and successfully resulted in sputum conversion.

• 대한임상검사과학회지
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• 제47권1호
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• pp.1-5
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• 2015

The nontuberculous mycobacteria (NTM) have been found in different environmental sources. They tend to colonize different body surfaces and secretions. The purpose of this study is to evaluate the presence of NTM in the theater environment. Fifty of Theater environment sample were examined using acid-fast stain, Lowenstein-Jensen medium culture, PCR and DNA-Sequencing. 4 of 50 samples were detected as NFB in AFB stain, L-J medium culture, PCR. and then, All of 4 NTM stains identified as Mycobacterium fortitum type in DNA-sequencing result.

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.1-5
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• 2014

The recovery of nontuberculous mycobacteria (NTM) from respiratory specimens and the number of patients with NTM lung disease have been rapidly increasing in Korea. An early differential diagnosis of NTM lung disease from pulmonary tuberculosis (TB) is important, as the therapeutic regimen differs from that of pulmonary TB, and it is not necessary to track the contacts of patients with NTM lung disease. However, differentiating NTM lung disease from pulmonary TB remains difficult, because the clinical presentations of the two diseases are similar and a definite diagnosis of NTM lung disease based on sputum culture takes time. This review focuses on the changing epidemiology, clinical and radiographic manifestation, and laboratory diagnosis of pulmonary TB and NTM lung disease in Korea.

• Tuberculosis and Respiratory Diseases
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• 제74권4호
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• pp.187-190
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• 2013

We report a rare case of lung disease caused by Mycobacterium lentiflavum in a previously healthy woman. A 54-year-old woman was referred to our hospital due to chronic cough and sputum. A computed tomography scan of the chest revealed bilateral bronchiectasis with bronchiolitis in the right middle lobe and the lingular division of the left upper lobe. Nontuberculous mycobacteria were isolated twice from three expectorated sputum specimens. All isolates were identified as M. lentiflavum by multilocus sequence analysis based on rpoB, hsp65, and 16S rRNA fragments. To the best of our knowledge, this is the first documented case of M. lentiflavum lung disease in an immunocompetent adult in Korea.

• 대한한방내과학회지
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• 제42권5호
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• pp.1148-1159
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• 2021

Objectives: This study investigated the effect of combined Korean medical treatment and antibiotics on a patient diagnosed with nontuberculous mycobacterial lung disease. Methods: The patient had been treated with antibiotics since July 2020 concurrently with Maekmoondong-tang, Banhasasim-tang, Gwakhyangjunggi-san and Bojungikgi-tang. The improvement of symptoms was evaluated using scores for the numerical rating scale (NRS), the Medical Research Council (MRC) dyspnea scale, C-reactive protein (CRP) levels, and computed tomography (CT). Results: Following treatment, the NRS, MRC dyspnea scale and CT images significantly improved. Also, CRP levels remained in the normal range during treatment. Conclusions: Traditional Korean medical treatment combined with antibiotics could be effective for treating patients with nontuberculous mycobacterial lung disease.

• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.74-84
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• 2016

Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.161-166
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• 2014

Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-TB, show equally high efficacy and safety. Systemic steroids may reduce the overall TB mortality attributable to all forms of TB across all organ systems, although inhaled corticosteroids can increase the risk of TB development. Although fixed dose combinations were expected to reduce the risk of drug resistance and increase drug compliance, a recent meta-analysis found that they might actually increase the risk of relapse and treatment failure. Regarding treatment duration, patients with cavitation and culture positivity at 2 months of TB treatment may require more than 6 months of standard treatment. New anti-TB drugs, such as linezolid, bedaquiline, and delamanid, could improve the outcomes in drug-resistant TB. Nontuberculous mycobacterial lung disease has typical clinical and immunological phenotypes. Mycobacterial genotyping may predict disease progression, and whole genome sequencing may reveal the transmission of Mycobacterium abscessus. In refractory Mycobacterium avium complex lung disease, a moxifloxacin-containing regimen was expected to improve the treatment outcome.