[A CASE OF PULMONARY MYCOBACTERIUM ABSCESSUS INFECTION THAT DEVELOPED DURING IMMUNOSUPPRESSIVE THERAPY FOR MYASTHENIA GRAVIS WITH RECURRENT THYMOMA].
A 58-year-old man developed cough, sputum, and low-grade fever during immunosuppressive treatment with corticosteroids and cyclosporine for myasthenia gravis with recurrent thymoma. Since chest CT revealed diffuse nodular opacities in both lung fields, he was referred to our department. Mycobacterium abscessus was repeatedly cultured from his sputum, and he was diagnosed with pulmonary M. abscessus infection. Although both chest radiological findings and clinical symptoms were mild, he required treatment with immunosuppressive agents and systemic anesthesia for resection of the recurrent thymoma. Based on complications and according to the patient's preference, oral treatment with clarithromycin 600 mg/day, levofloxacin 500 mg/day, and faropenem 600 mg/day was initiated on an outpatient basis. Following these treatments, his chest CT findings and clinical symptoms subsided, and the thymoma was successfully resected. Our experience with the present case suggests a possible treatment strategy for M. abscessus infection in immunocompromised and complicated cases.
Hiroto
H
Matsuse
Takeshi
T
Oshio
Kumiko
K
Kishimoto
Haruo
H
Nakayama
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D064704:Levofloxacin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications / Q000188:drug therapy*; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy* / Q000209:etiology*; D009364:Neoplasm Recurrence, Local; D013945:Thymoma / Q000150:complications / Q000601:surgery*; D013953:Thymus Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D047090:beta-Lactams / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D047090:beta-Lactams; D064704:Levofloxacin; D016572:Cyclosporine; C107057:fropenem; D017291:Clarithromycin