肺非定型抗酸菌症のX線学的研究

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書誌事項

タイトル別名
  • ROENTGENOLOGICAL STUDIES OF LUNG DISEASE DUE TO MYCOBACTERIA OTHER THAN TUBERCLE BACILLI
  • ハイ ヒ テイケイ コウサンキンショウ ノ Xセンガクテキ ケンキュウ 2 シ
  • The second report: On the Course of the Progression of Pulmonary Lesions in the Fatal Cases
  • 第2報死亡例における病変の進展経過について

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Sixty seven cases with pulmonary atypical mycobacteriosis (2 by M. kansasii, 62 by M. intracellulare, 2 by M. fortuitum and 1 by a possible new pathogen of group III mycobacteria) died in 9 Japanese national sanatoria up to October 1976.<BR>Of these 67 cases, 40 died of atypical mycobacterial disease, and the remaining 27 cases died of other diseases. Roentgenological aggravation was found in 44 cases (1 by M. kansasii, 1 by M. fortuitum and 42 by M. intracellulare).<BR>There were various types of roentgenological aggravation. Spread of non-cavitary foci, infiltrate and pneumonia were found most frequently (40/44, 90.9%). Enlargement of cavity was found in 12 cases (27.2%), appearance of pleural effusion in 5 cases (11.4%), and spontaneous pneumothorax in 3 cases.<BR>Infection of bulla was found in 11 out of 22 cases with bullae as the underlying disease.<BR>The first roentgenological aggravation was found in 20 (45.5%) out of 44 cases within 12 months; 13 cases (29.5%) between 13 to 24 months; and 11 cases (25%) over 2 years after the discovery of the disease.<BR>From the results mentioned above, in the fatal cases, progression of the disease was predicted by the appearance of the roentgenological aggravation within 2 years after the discovery of the disease.<BR>There were various courses of the progression of the lesions as shown in Figures 2a and 2b. One of the typical course of the progression was devided into the following 5 stages:<BR>The first stage: localized cavitary lesion.<BR>The second stage: spread of foci around cavity.<BR>The third stage: spread of foci in contralateral lung.<BR>The fourth stage: enlargement of cavity (appearance of giant cavity).<BR>The fifth stage: extensive pneumonia in the lower lung field. Another typical course of the progression was the repeated infections of bullae.<BR>Roentgenological aggravation found in patients with atypical mycobacterial disease was not rarely due to the mixed infection with various organisms (gram-negative bacilli, fungi and also human type tubercle bacilli).<BR>The majority of the patients with underlying pulmonary disease (extensive emphysema, chronic bronchitis and bronchiectasis) died of pulmonary insufficiency in the relatively early stage of atypical mycobacteriosis.<BR>The patients with the mixed infection have died, in spite of the negative conversion or the dicrease of the excretion of atypical mycobacteria.<BR>There were two cases (M. intracellulare infection) complicated with pulmonary tuberculosis.

収録刊行物

  • 結核

    結核 53 (2), 99-105, 1978

    一般社団法人 日本結核病学会

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