Co-existence of Mycobacterium tuberculosis and Mycobacterium intracellulare in one sputum sample.
An 81-year-old man was admitted to the hospital with a severe sore throat and a low grade fever. A chest radiograph showed bilateral diffuse reticulonodular shadows. By fluorescent stain for mycobacteria, his sputum smear showed acid-fast bacteria. The initial polymerase chain reaction (PCR) of his sputum revealed Mycobacterium intracellulare (M. intracellulare), but not Mycobacterium tuberculosis (M. tuberculosis). However, a repeat PCR was performed because M. tuberculosis could not be ruled out due to his clinical symptoms and chest imaging. The second PCR detected both M. intracellulare and M. tuberculosis. From the standpoint of infection control, this case illustrates the possibility that M. tuberculosis could be a threat if a second PCR is not done. While PCR is a useful exam for diagnosing M. tuberculosis, it can produce false negative results. Therefore, for diagnosing tuberculosis, particularly in a case such as the present case, a second PCR, which is not normally necessary, should be done.
Department of Clinical and Laboratory Medicine, Akita University School of Medicine, Akita.
Masahide
M
Takeda
Wataru
W
Ito
Noriko
N
Kobayashi
Keiko
K
Konno
Tomoe
T
Takahashi
Rumi
R
Tatsuko
Noriko
N
Tomita
Tomomi
T
Tanigai
Takahito
T
Chiba
Kazutoshi
K
Yamaguchi
Kazuhiro
K
Sato
Shigeharu
S
Ueki
Hiroyuki
H
Kayaba
Junichi
J
Chihara
D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015269:Mycobacterium avium Complex / Q000235:genetics / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D013183:Sputum / Q000382:microbiology; D014387:Tuberculosis, Laryngeal / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents