title: [Mycobacterium abscessus group lung disease: case reports and review of the literature].
abstract: OBJECTIVE
  To analyze the clinical manifestations and efficacy of a combination antibiotic therapy including cefoxitin for Mycobacterium abscessus (M.abscessus) group lung disease.
  
  
  METHODS
  We retrospectively analyzed the clinical manifestations of 16 patients with M.abscessus group lung disease, and the responses of 5 cases treated with whole-course clarithromycin and moxifloxacin, initially intensified with intravenous amikacin and cefoxitin therapy for the first 12 weeks.
  
  
  RESULTS
  Radiological study showed that 14 patients with M.abscessus group pulmonary disease were classified as nodular bronchiectasis form, and 1 patient as upper lobe cavity form and 1 patient was unclassifiable. The radiological characteristics of M.abscessus group pulmonary disease included multiple micronodules (14/16), bronchiectasis (14/16), tree in bud sign (13/16), cavity (5/16), consolidation (5/16), nodules (5/16), and collapse of lung (3/16). Five cases were treated with a combination antibiotic therapy including cefoxitin. After 3 months treatment for the initial phase, 2 of them got improvement in symptoms, CT manifestations and sputum conversion. Two of them improved in symptoms and CT manifestations, but not in sputum conversion. One case showed no improvement in the initial phase, and continuation therapy also failed to improve symptoms, CT abnormalities or sputum conversion.
  
  
  CONCLUSIONS
  Nodular bronchiectasis is the main manifestation of M.abscessus group lung disease. The main imaging characteristics included multiple micronodules, bronchiectasis and tree in bud sign. A therapeutic regimen including cefoxitin may be moderately effective in treating M.abscessus group lung disease.
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China.
authors.forename: Hong-fei
authors.initials: HF
authors.lastname: Duan
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China.
authors.forename: Nai-hui
authors.initials: NH
authors.lastname: Chu
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China. Email:wangqingf511@sohu.com.
authors.forename: Qing-feng
authors.initials: QF
authors.lastname: Wang
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China.
authors.forename: Hai-rong
authors.initials: HR
authors.lastname: Huang
authors.affiliation: Department of Tuberculosis, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Liang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy; D009170:Nontuberculous Mycobacteria; D012189:Retrospective Studies