Non-tuberculous Mycobacterial Lung Disease Presenting as a Solitary Pulmonary Nodule.

Kim, Song Yee; Lee, Kyung Jong; Lee, Sang Hoon; Lee, Sang Kook; Park, Byung Hoon; Jung, Ji Ye; Son, Ji Young; Yoon, Yoe Wun; Shim, Hyo Sup; Kang, Young Ae; Park, Moo Suk; Kim, Young Sam; Chang, Joon; Kim, Se Kyu; Moon, Jin Wook

doi:2010.69.1.43

Tuberc Respir Dis > Volume 69(1); 2010 > Article

Case Report

Tuberculosis and Respiratory Diseases 2010;69(1):43-47.
DOI: https://doi.org/10.4046/trd.2010.69.1.43 Published online July 1, 2010.

Non-tuberculous Mycobacterial Lung Disease Presenting as a Solitary Pulmonary Nodule.

Song Yee Kim, Kyung Jong Lee, Sang Hoon Lee, Sang Kook Lee, Byung Hoon Park, Ji Ye Jung, Ji Young Son, Yoe Wun Yoon, Hyo Sup Shim, Young Ae Kang, Moo Suk Park, Young Sam Kim, Joon Chang, Se Kyu Kim, Jin Wook Moon

¹Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. jwmoon@yuhs.ac
²Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
³The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

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.

Key Words: Mycobacterium Infections, Atypical, Solitary Pulmonary Nodule, Tuberculosis