title: Solitary pulmonary nodule due to Mycobacterium intracellulare: the first case in Korea.
abstract: Here, we describe a case of a solitary pulmonary nodule due to Mycobacterium intracellulare infection. To the best of our knowledge, this is the first case reported in Korea. A 45-year- old female, exhibiting no respiratory symptoms, was admitted to our hospital due to the appearance of a solitary pulmonary nodule on a chest radiograph. Computed tomography revealed a 2.5 cm nodule with an irregular shape and some marginal spiculation in the right upper lobe. Positron emission tomography with fluorodeoxyglucose imaging revealed positive tumor uptake (maximum standardized uptake value=8.8). Bronchoscopy yielded no specific histological findings and no bacteriological findings. Percutaneous transthoracic lung biopsy revealed epithelioid granuloma but no acid-fast bacilli were detected. The patient received isoniazid, rifampin, ethambutol, and pyrazinamide for the treatment of "tuberculoma". Five weeks after the patient was admitted, numerous mycobacterial colonies were detected on a bronchial washing fluid culture. These colonies were subsequently identified as Mycobacterium intracellulare. A final diagnosis of M. intracellulare pulmonary disease was made, and the patient's treatment regimen was changed to a combination therapy consisting of clarithromycin, rifampin, and ethambutol.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Kwon
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.forename: Eun Yoon
authors.initials: EY
authors.lastname: Cho
authors.forename: Joungho
authors.initials: J
authors.lastname: Han
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Kim
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
mesh_terms: D005260:Female; D006801:Humans; D007723:Korea; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D003074:Solitary Pulmonary Nodule / Q000382:microbiology / Q000473:pathology*; D014397:Tuberculosis, Pulmonary / Q000382:microbiology / Q000473:pathology*