title: [A case of pulmonary atypical mycobacteriosis complicated with aplastic anemia, treated with surgical resection and postoperative sparfloxacin].
abstract: A few weeks after treatment with INH, RFP and SM, severe aplastic anemia developed in a 49-year-old man with pulmonary atypical mycobacteriosis due to M. kansasii. All drugs were discontinued immediately after bone marrow examination revealed severely hypoplastic marrow, but pancytopenia continued for several months. Although M. kansasii was sensitive to other drugs including CS and TH, these two drugs were also discontinued because of their respective psychiatric and hepatic adverse effects. Ofloxacin (OFLX), to which M. kansasii was sensitive, was administered without clinical improvement and complete resistance to OFLX developed after several months treatment. Right upper and middle lobectomy and S6 partial lobectomy was performed, and postoperative sparfloxacin (SPFX) administration resulted in cure of the disease. Drug sensitivity testing revealed that the organism had acquired resistance to OFLX, but was still sensitive to SPFX. Thus, SPFX appears to be an useful drug for the treatment of atypical mycobacteriosis.
authors.affiliation: Department of Medicine, National Sanatorium Minamiokayama Hospital.
authors.forename: S
authors.initials: S
authors.lastname: Yoshimoto
authors.forename: H
authors.initials: H
authors.lastname: Konishi
authors.forename: S
authors.initials: S
authors.lastname: Kawahara
authors.forename: A
authors.initials: A
authors.lastname: Tada
authors.forename: K
authors.initials: K
authors.lastname: Shiomi
authors.forename: M
authors.initials: M
authors.lastname: Takeuchi
authors.forename: K
authors.initials: K
authors.lastname: Kamisaka
authors.forename: Y
authors.initials: Y
authors.lastname: Mishima
authors.forename: T
authors.initials: T
authors.lastname: Matsuyama
authors.forename: M
authors.initials: M
authors.lastname: Kibata
mesh_terms: D000741:Anemia, Aplastic / Q000150:complications*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000628:therapy; D011013:Pneumonectomy; D015363:Quinolones / Q000627:therapeutic use*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000628:therapy
chemical_list: D000890:Anti-Infective Agents; D000995:Antitubercular Agents; D024841:Fluoroquinolones; D015363:Quinolones; C061363:sparfloxacin