[Nontuberculous mycobacteriosis as a complication of the Swyer-James syndrome].
The chest radiograph of a 35-year-old man with fatigue, exertional dyspnoea and haemoptyses revealed a cavity in the left upper lobe and a shrunken left lung with radiolucency greater than that on the right. Acid-fast rods in sputum were identified as Mycobacterium kansasii on culture. Scintigraphy showed a 9% residual perfusion on the left and abnormal ventilation, compatible with Swyer-James syndrome. This had favoured the development of a mycobacterial infection. There was also a decrease in ciliary function (rate of 4-7 Hz, normal: 10-11). Treatment, begun when tuberculosis had been suspected, was after sensitivity tests changed to a combination of rifampicin (600 mg), ethambutol (1600 mg) and protionamide (500 mg) daily. There was marked regression of the findings within 4 weeks, but treatment was prematurely stopped after 11 months. Two years later there was a recurrence which again responded well to the same drug regimen with additional sulphamethoxazole (1600 mg/d).
Matthiessen
W
W
Zentrum für Pneumologie und Thoraxchirurgie, Fachkrankenhaus Coswig.
Schönfeld
N
N
Mauch
H
H
Wahn
U
U
Grassot
A
A
D000328:Adult; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D006801:Humans; D008168:Lung / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D011656:Pulmonary Emphysema / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011877:Radionuclide Imaging; D012008:Recurrence; D013183:Sputum / Q000382:microbiology; D013577:Syndrome; D013667:Technetium; D014057:Tomography, X-Ray Computed
D013667:Technetium