title: A Case of Rapid Exacerbation of Pulmonary Mycobacterium Avium Complex Infection Mimicking Pulmonary Aspergillosis.
abstract: We herein report a case of pulmonary Mycobacterium avium complex (MAC) infection with pulmonary multiple nodules and the "halo sign" on chest computed tomography (CT) in which the patient showed rapid exacerbation seven years after undergoing bone marrow transplantation (BMT). A 68-year-old Japanese female visited our hospital due to a productive cough and dyspnea. She had undergone allogeneic BMT for acute myelocytic leukemia and received both prednisolone (2 mg/day) and cyclosporine (30 mg/day). Chest CT demonstrated no abnormal findings on admission; however, multiple pulmonary nodules and the "halo sign" were detected three weeks later. Although a fungal infection was initially suspected, a bronchoscopic examination revealed pulmonary MAC infection. In the present case, pulmonary MAC infection exhibited rapid progression with unique CT findings. Physicians should consider MAC infection in the differential diagnosis in patients who receive BMT and/or immunosuppressive agents, even if the clinical and radiological findings are atypical of the disease.
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Noguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawanami
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Ikuko
authors.initials: I
authors.lastname: Shimabukuro
authors.forename: Kentarou
authors.initials: K
authors.lastname: Akata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujii
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yoshii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
mesh_terms: D000368:Aged; D016026:Bone Marrow Transplantation; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008171:Lung Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000503:physiopathology*; D011140:Polyurethanes; D055732:Pulmonary Aspergillosis / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
chemical_list: D011140:Polyurethanes; C528226:thoralon