Korean J Radiol.  2014 Oct;15(5):651-654. 10.3348/kjr.2014.15.5.651.

Mycobacterium Szulgai Pulmonary Infection: Case Report of an Uncommon Pathogen in Korea

• Kim JJ
• Lee J
• Jeong SY

• KMID: 1734952
• DOI: http://doi.org/10.3348/kjr.2014.15.5.651

Abstract

Mycobacterium szulgai (M. szulgai) is an unusual pathogen in a human non-tuberculous mycobacterial infection. Pulmonary infection due to M. szulgai may be clinically and radiologically confused with active pulmonary tuberculosis. In contrast to other non-tuberculous mycobacteria, M. szulgai infection is well controlled by combination antimycobacterial therapy. Most of the previously reported cases of M. szulgai pulmonary infection showed cavitary upper lobe infiltrates. We herein describe a case of pulmonary M. szulgai infection that shows clinical and radiological presentations similar to active pulmonary tuberculosis.

Keyword

Mycobacterium szulgai; Nontuberculous mycobacteria; Pulmonary infection

MeSH Terms

Aged
Antitubercular Agents/therapeutic use
Humans
Male
Mycobacterium Infections, Nontuberculous/drug therapy/*radiography
Nontuberculous Mycobacteria/*isolation & purification
Republic of Korea
Tomography, X-Ray Computed
Antitubercular Agents

Figure

• 

  Fig. 1 55-year-old man with Mycobacterium szulgai pulmonary disease. A. Initial chest radiograph shows dense peribronchial consolidation containing cavity in left suprahilar area. Note multiple tiny nodules in both lungs. B, C. Lung window images of initial chest high resolution chest computed tomography (HRCT) (1.0-mm section thickness) at levels of aortic arch (B) and bronchus intermedius (C), respectively, show dense peribronchial consolidation containing bronchiectatic cavity in left upper lobe and multiple small nodules and branching linear opacities (tree-in-bud pattern) in left lower lobe. Note multiple small well-defined nodules in right lung with centrilobular and perilymphatic distribution, which are considered to be silicotic nodules. D, E. Lung window images of follow-up chest HRCT obtained 4 months after treatment demonstrate interval decreased extent of peribronchial consolidation and nodular infiltrates in left lung. No significant interval change is noted in extent of silicotic nodules. F. Follow-up chest radiograph 6 months after treatment shows decreased extent of pulmonary infiltrates in left lung.

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