[A CASE OF PULMONARY MYCOBACTERIUM ABSCESSUS INFECTION THAT DEVELOPED DURING IMMUNOSUPPRESSIVE THERAPY FOR MYASTHENIA GRAVIS WITH RECURRENT THYMOMA].

Kekkaku : [Tuberculosis] Pub Date : 2016-02-01
Hiroto Matsuse, Takeshi Oshio, Kumiko Kishimoto, Haruo Nakayama
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Abstract

A 58-year-old man developed cough, sputum, and low-grade fever during immunosuppressive treatment with corticosteroids and cyclosporine for myasthenia gravis with recurrent thymoma. Since chest CT revealed diffuse nodular opacities in both lung fields, he was referred to our department. Mycobacterium abscessus was repeatedly cultured from his sputum, and he was diagnosed with pulmonary M. abscessus infection. Although both chest radiological findings and clinical symptoms were mild, he required treatment with immunosuppressive agents and systemic anesthesia for resection of the recurrent thymoma. Based on complications and according to the patient's preference, oral treatment with clarithromycin 600 mg/day, levofloxacin 500 mg/day, and faropenem 600 mg/day was initiated on an outpatient basis. Following these treatments, his chest CT findings and clinical symptoms subsided, and the thymoma was successfully resected. Our experience with the present case suggests a possible treatment strategy for M. abscessus infection in immunocompromised and complicated cases.

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[重症肌无力伴复发性胸腺瘤免疫抑制治疗期间发生肺脓肿分枝杆菌感染1例]。
一名58岁男性在使用皮质类固醇和环孢素免疫抑制治疗重症肌无力合并复发性胸腺瘤时出现咳嗽、痰和低烧。由于胸部CT显示双肺弥漫性结节性混浊,他被转介到我科。痰中反复培养脓肿分枝杆菌,诊断为肺脓肿分枝杆菌感染。虽然胸部影像学表现和临床症状都很轻微,但他需要免疫抑制剂治疗和全身麻醉来切除复发的胸腺瘤。根据并发症和患者的偏好,门诊开始口服克拉霉素600 mg/天,左氧氟沙星500 mg/天,法罗培南600 mg/天。经过这些治疗,他的胸部CT表现和临床症状消退,胸腺瘤成功切除。我们的经验与本病例建议一个可能的治疗策略脓肿分枝杆菌感染在免疫功能低下和复杂的情况下。
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