Tuberc Respir Dis.  2013 Apr;74(4):191-194. 10.4046/trd.2013.74.4.191.

Nontuberculous Mycobacterial Lung Disease Caused by Mycobacterium chelonae: A Case Report

• Ko Y
• Kim W
• Shin BS
• Yoo H
• Eom JS
• Lee JH
• Jhun BW
• Kim SY
• Choi GE
• Shin SJ
• Koh WJ

• KMID: 1495861
• DOI: http://doi.org/10.4046/trd.2013.74.4.191

Abstract

Mycobacterium chelonae lung disease is very rare. We report a case of lung disease caused by M. chelonae in a previously healthy woman. A 69-year-old woman was referred to our hospital because of hemoptysis. A computed tomography (CT) scan of the chest revealed bronchiolitis associated with bronchiectasis in the lingular division of the left upper lobe. Nontuberculous mycobacteria were isolated three times from sputum specimens. All isolates were identified as M. chelonae by various molecular methods that characterized rpoB and hsp65 gene sequences. Although some new lesions including bronchiolitis in the superior segment of the left lower lobe developed on the chest CT scan 35 months after diagnosis, she has been followed up without antibiotic therapy because of her mild symptoms. To the best of our knowledge, this is the first case of M. chelonae lung disease in Korea in which the etiologic organisms were confirmed using molecular techniques.

Keyword

Nontuberculous Mycobacteria; Bronchiectasis; Mycobacterium chelonae

MeSH Terms

Bronchiectasis
Bronchiolitis
Female
Hemoptysis
Humans
Korea
Lung
Lung Diseases
Mycobacterium
Mycobacterium chelonae
Nontuberculous Mycobacteria
Sputum
Thorax

Figure

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  Figure 1 A 69-year-old woman with bronchiectasis and nontuberculous mycobacterial lung disease caused by Mycobacterium chelonae. (A) A transverse computed tomography (CT) scan (2.5-mm-section thickness) at the time of presentation reveals bronchiectasis and bronchiolitis in the lingular division of the left upper lobe. (B) Mild bronchiectasis was noted in the superior segment of the left lower lobe at the time of presentation. (C) A CT scan of the same patient at 3 years after diagnosis reveals mild progression of peribronchial infiltration on the lingular division of the left upper lobe. (D) There was newly appearing bronchiolitis in the superior segment of the left lower lobe.

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  Figure 2 Electrophoresis of the polymerase chain reaction-restriction fragment length polymorphism analysis (PRA) of the rpoB gene involving digestion with Msp I. Mycobacteria isolated from two serial specimens generated the fragments of 105, 95, 80, 50, and 40 bp, which were identical to those of Mycobacterium chelonae subsp. chelonae ATCC35749. M, size marker; Lanes 1 and 2, patterns of rpoB-PRA from two serial samples isolated; Lane 3, the matched pattern of the reference strain M. chelonae subsp. chelonae ATCC35749.

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