Mycobacterium Avium - in tracellulare Complex 와 M . Fortuitum 에 의한 폐항산균증(肺抗酸菌症) 3예 = Nontuberculous Pulmonary Infection in Two Patients with Mycobacterium avium - in tracellulare Complex and a Patient with M . fortuitum

다국어 초록 (Multilingual Abstract)

Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex (MAIC) and a case of pulmonary infection in a 69 year-old male patient due to M fortuitum (MF) were found recently in this institute. All three patients bad a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis.
A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid (INH), para-aminosalicylic acid (PAS) and streptomycin (SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M tuberculosis at all.
A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide (PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide (TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1983 and he continuously discharged the same baeilli until last examination of January l982.
Whether all three patients were initially infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological Examination records.