[Three sisters of pulmonary Mycobacterium avium complex disease].
We reported three sisters of pulmonary Mycobacterium avium complex (MAC) disease. The oldest sister was complaining of bloody sputum, and cultures were positive for M. avium. By monotherapy with clarithromycin, symptom and imaging findings had shown no progression for six years. The second sister was complaining of productive cough, and cultures were positive for M. intracellulare. Her symptom and imaging findings had shown no progression for seven years without any treatment. The third sister had rheumatoid arthritis and diabetes mellitus, and cultures were positive for M. intracellulare. Although she received chemotherapy with rifampicin, clarithromycin, ethambutol, and kanamycin, symptom and imaging findings had progressed gradually. She died of respiratory failure four years later. Autopsy findings revealed no disseminated MAC disease. The results which three cases showed different isolate patterns and clinical courses suggest the importance of underlying anti-mycobacterial immunological impairment and defects of local host defense rather than virulence of infected strains as the pathogenesis of pulmonary MAC disease.
Inoue
Tetsuro
T
Department of Respiratory Medicine, TENRI Hospital.
Tanaka
Eisaku
E
Sakuramoto
Minoru
M
Minakuchi
Masayoshi
M
Maeda
Yuji
Y
Maniwa
Ko
K
Terada
Kunihiko
K
Goto
Shunsuke
S
Takeda
Tomoshi
T
Okamoto
Masaki
M
Asano
Hiroshi
H
Komatsu
Masaru
M
Iwasaki
Mizuho
M
Nagasaka
Yoko
Y
Taguchi
Yoshio
Y
D000368:Aged; D005192:Family Health; D005260:Female; D006801:Humans; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics*