Mycobacterium intracellulareとMycobacterium fortZtititm(subsp.abscessus)との混合感染を示した1例

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A case of simultaneous infection with Mycobacterium intracellulare and Mycobacterium fortuitum (subsp. abscessus) is described. The patient is born in April 1927 in Aichi-Prefecture and is a married woman. She had cough and sputa in March 1966 and entered this hospital under diagnosis of pulmonary tuberculosis with a cavity in the left upper lobe. She was suspected of infection with atypical mycobacteria by growth of her bacilli on salicylate medium (Ogawa egg medium containing 0.5mg/m/ sodium salicylate (9)) and growth on all media containing antituberculous agents inspite of absence of previous treatment with antituberculous agents. By examination of the organism excreted to sputum, the organism was identified as M. f ortuitum subsp. abscessus. After administration of antituberculous agents, which wer e considered to be ineffective according to drug resistance tests, the cavity of the left upper lobe was markedly decreased and appeared as if disappeared on a X-ray figure. In February 1967, she received resection of the left upper lobe. Result of cultivation of cavity wall and a part of lung with cavity showed growth of 36 colonies after 5 months. This organism was identified as M. intracellulare, but a varity showing very slow growth. It was suggested that this slow growth may be due to lack of ability to utilize many nitrogen compounds. Course of excretion of acid-fast organism, chemotherapy ap p licated, result of drug resistance tests, course of change of X-ray figure, tuberculin reaction, biologic and biochemical characters of the organisms isolated, and virulence for mice are shown in tables and figure. The patient is excreting M. f ortuitum even after the resection of the left upper lob e and is considered that the organism is infected at a site other than the cavity of the left upper lobe. From the cavity, only M. intracellulare was found. It is noteworthy that even an organism b e l onging to a rapid grower shows very slow growth at primary isolation from sputum, but it shows rapid growth (growth at 3 days on egg media)at secondary cultures. The M. intracellulare isolated in this case showed very slow growth, a little slower than M. tuberculosis.
日本結核病学会の論文

Mycobacterium intracellulareとMycobacterium fortZtititm(subsp.abscessus)との混合感染を示した1例

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