Three Sisters of Pulmonary <I>Mycobacterium avium</I> Complex Disease

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Other Title
  • 肺<I>Mycobacterium avium</I> complex (MAC) 症の3姉妹例
  • 症例 第45回日本感染症学会中日本地方会総会学術奨励賞 肺Mycobacterium avium complex(MAC)症の3姉妹例
  • ショウレイ ダイ45カイ ニホン カンセンショウ ガッカイ ナカニホン チホウカイ ソウカイ ガクジュツ ショウレイショウ ハイ Mycobacterium avium complex MAC ショウ ノ 3 シマイレイ
  • Three Sisters of Pulmonary Mycobacterium avium Complex Disease

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Description

We reported three sisters of pulmonary Mycobacterium avium complex (MAC) disease. The oldest sister was complaining of bloody sputum, and cultures were positive for M. avium. By monotherapy with clarithromycin, symptom and imaging findings had shown no progression for six years. The second sister was complaining of productive cough, and cultures were positive for M. intracellulare. Her symptom and imaging findings had shown no progression for seven years without any treatment. The third sister had rheumatoid arthritis and diabetes mellitus, and cultures were positive for M. intracellulare. Although she received chemotherapy with rifampicin, clarithromycin, ethambutol, and kanamycin, symptom and imaging findings had progressed gradually. She died of respiratory failure four. years later. Autopsy findings revealed no disseminated MAC disease. The results which three cases showed different isolate patterns and clinical courses suggest the importance of underlying anti-mycobacterial immunological impairment and defects of local host defense rather than virulence of infected strains as the pathogenesis of pulmonary MAC disease.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 79 (5), 341-347, 2005

    The Japanese Association for Infectious Diseases

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