肺結核の遺残空洞への<I>Mycobacterium avium-intracellulare</I> Complexの二次感染例

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Previously, Tsukamura (Amer. Rev. Resp. Dis., 108: 679, 1973; Tap. J. Chest Dis., 32: 23, 1973; Kekkaku, 50: 17, 1975) reported that ‘open-negative’ cavities of lung tuberculosis can be infected with <I>M. avium-intracellulare</I> complex organisms. After these observations, two additional cases were found.<BR>A patient (case 1) was hospitalized showing a large cavity in 1965. The patient did not excret any acid-fast organism during more than 10 years observation period. She begann to show continuous excretion of <I>M. avium-intracellulare</I> complex from 1975. No significant deterioration of X-ray findings was observed before and after the infection of the cavity with these organisms.<BR>Another patient (case 2) was hospitalized showing continuous excretion of tubercle bacilli and showing multiple cavities in her right lung. She received a total resection of the right lung. After the surgical treatment, <I>M. avium-intracellulare</I> complex were isolated several times from sputum.<BR>Lung infection due to <I>M. avium-intracellulare</I> complex is regarded as an opportunistic infection, and the infection due to this organism occurs in patients with reduced general or local resistance. The former usually shows the ‘primary infection-type’ and the latter the ‘secondary infection-type’ in X-ray findings (Tsukamura, M.: Kekkaku, 50: 17, 1975). The background of the secondary infection in this country is often cavities of lung tuberculosis which ceased to excrete tubercle bacilli after chemotherapy. The disease of this type shows cavities in sclerotic lesion or cavities with sclerotic wall. The X-ray picture is almost the same before and after the onset of disease. The cases in the present study are examples of the secondary infection.
日本結核病学会の論文

著者

束村道雄
国立療養所中部病院

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