Tuberc Respir Dis.  2003 Jan;54(1):45-56. 10.4046/trd.2003.54.1.45.

Clinical and Radiographic Characteristics of 12 Patients with Mycobacterium abscessus Pulmonary Disease

• Koh WJ
• Kwon OJ
• Kang EH
• Jeon IS
• Pyun YJ
• Ham HS
• Suh GY
• Chung MP
• Kim HJ
• Han DH
• Kim TS
• Lee KS

• KMID: 1883782
• DOI: http://doi.org/10.4046/trd.2003.54.1.45

Abstract

BACKGROUND: Mycobacterium abscessus is the most common respiratory pathogen in rapidly growing mycobacteria and is resistant to all of the first-line antituberculosis drugs. This report describes the clinical and radiographic characteristics in patients with pulmonary disease caused by M. abscessus.
MATERIALS AND METHODS
Twelve patients with pulmonary disease caused by M. abscessus who fulfilled the 1997 American Thoracic Society diagnostic criteria for a nontuberculous mycobacterial pulmonary infection were observed over a five-and-a-half year period. The clinical characteristics and chest radiographic findings were analyzed, retrospectively.
RESULTS
The patients were predominantly female(11/12, 92%) and nonsmokers(12/12, 100%). Coughing (10/12, 83%), sputum(10/12, 83%) and hemoptysis(10/12, 83%) were the common symptoms and they had prolonged periods from the onset of symptoms to the diagnosis of their disease(median 6.5 years). Eleven (92%) patients had a previous history of being treated for pulmonary tuberculosis. The sputum specimens were acid-fast bacilli smear-positive in all patients. All patients were administered antituberculosis drugs. Six (50%) patients were treated with second-line antituberculosis drugs on account of persistent smear-positive sputum specimens. The chest radiographs showed that reticulonodular opacities(11/12, 92%) were the most common pattern of abnormality, followed by cavitary lesions(5/12, 42%). The computed tomography findings suggested bronchiolitis from the centrilobular nodules with a tree-in-bud appearances(9/10, 90%) and bronchiectasis (9/10, 90%) were the most common, followed by well-defined nodules smaller than 10-mm in diameter(7/10, 70%).
CONCLUSIONS
M. abscessus pulmonary disease should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.

Keyword

Atypical mycobacteria; Mycobacterium abscessus; Lung diseases; Korea

MeSH Terms

Bronchiectasis
Bronchiolitis
Cough
Diagnosis
Humans
Korea
Lung Diseases*
Mycobacterium*
Nontuberculous Mycobacteria
Radiography, Thoracic
Retrospective Studies
Sputum
Tuberculosis, Pulmonary