Roentgenological evaluation of human atypical mycobacteriosis

Cho, O K; Lee, Y H; Lew, J; Oh, K K; Choi, B S; Choi, T K

Abstract

The incidence of atypical mycobacteriosis is rising, however, the clinical, pathologic and radiographicaspects of atypical mycobacteriosis are generally indistinguishable from those of tuberculosis. There is muchdifferences in epidemiology, diagnosis and therapy between them, it should be clearly differentiated fromtuberculosis, At this point, we reviewed 19 cases of confirmed mycobacteriosis and 100 cases of usual tuberculosisby the way of chest film, and found certain roentgenfreatures that might suggest the possibility of atypicalmycobacteriosis as follow. 1. Among the 19 cases of atypical mycobacteriosis, group III (Nonchromogens) is highestin number of 12 cases but group I (photochrmomogen) is not noticed. 2. Inspite of the advanced extent of diseseinroentgenogram, tuberculin skin tests are negative or weakly positive. 3. Cavitation appaears to be ore commonwith atypical mycobacteriosis than tuerculosis. Multiple thin walled cavities are more prominent and the incidenceof air fluid level in the cavity is somewhat higher than tuberculosis. 4. The presence of preexisting pulmonarydisease is more noted in atypical mycobacteriosis particularly of emphysema. 5. Lack of fibrosis, calcificationand hilum elevation with healing process of atypical muycobacteriosis is charatristic findings. 6. Atypicalmycobacteriosis are frequently resistant to antituberculous drug therapy, so roentgenological improvement in 1year follow up film shows less effectiveness in atypical mycobacteriosis with even aggravation. 7. Extrapulmonarymanifestations atypical mycobacteriosis are noted in 3 cases due to group III, involving lumbar spine, meningesand large bowel.