[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.
Department of Respiratory Medicine, TENRI Hospital.
Tetsuro
T
Inoue
Eisaku
E
Tanaka
Minoru
M
Sakuramoto
Masayoshi
M
Minakuchi
Yuji
Y
Maeda
Ko
K
Maniwa
Kunihiko
K
Terada
Shunsuke
S
Goto
Tomoshi
T
Takeda
Masaki
M
Okamoto
Hiroshi
H
Asano
Masaru
M
Komatsu
Mizuho
M
Iwasaki
Yoko
Y
Nagasaka
Yoshio
Y
Taguchi
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*