Tuberc Respir Dis.  2010 Sep;69(3):201-206.

Two Cases of Nontuberculous Mycobacterial Lung Disease in Heart Transplant Recipients

• Jo JM
• Shin MS
• Kim JH
• Kim MJ
• Park HJ
• Na HK
• Jo KU
• Kim JJ
• Shim TS

Abstract

Nontuberculous mycobacterial (NTM) diseases are increasing worldwide. However NTM lung disease in organ transplant recipients has been rarely reported. Here, we report 2 cases of NTM lung disease in heart transplant recipients. A 37-year-old man, who had undergone a heart transplant one year previous, was admitted to hospital due to a cough. Chest CT scan showed multiple centrilobular nodules in both lower lungs. In his sputum, M. abscessus was repeatedly identified by rpoB gene analysis. The patient improved after treatment with clarithromycin, imipenem, and amikacin. An additional patient, a 53-year-old woman who had undergone a heart transplant 4 years prior and who suffered from bronchiectasis, was admitted because of purulent sputum. The patient's chest CT scan revealed aggravated bronchiectasis; M. intracellulare was isolated repeatedly in her sputum. Treatment was successfully completed with clarithromycin, ethambutol, and ciprofloxacin. NTM lung disease should be considered as a potential opportunistic infection in organ transplant recipients.

Keyword

Mycobacteria, Atypical; Heart Transplantation; Lung Diseases

MeSH Terms

Adult
Amikacin
Bronchiectasis
Ciprofloxacin
Clarithromycin
Cough
Ethambutol
Female
Heart
Heart Transplantation
Humans
Imipenem
Lung
Lung Diseases
Middle Aged
Nontuberculous Mycobacteria
Opportunistic Infections
Sputum
Thorax
Transplants
Amikacin
Ciprofloxacin
Clarithromycin
Ethambutol
Imipenem

Figure

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  Figure 1 HRCT scan showed multiple centrilobular nodules with branching linear opacity and bronchiectasis predominantly in both lower lobes (A, B). After treatment for M. abscessus, the lesions were resolved (C, D).

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  Figure 2 On OMU CT scan, severe sinusitis and polyposis were seen in both maxillary and ethmoid sinuses.

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  Figure 3 Chest CT scan showed bronchiectasis and combined bronchopneumonia in the right middle lobe (A) and left lower lobe (B). Those were improved after treatment with clarithromycin and ethambutol (C, D).

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