免疫正常患者鸟分枝杆菌肺病：病例报告及文献复习.docVIP

  Mycobacterium avium lung disease in an immunocompetent patient: a case report and literature review# XU Jinfu, LI Huiping** 5 10 (Shanghai Pulmonary Hospital, Tongji University School of Meidicine, ShangHai 200433) Abstract: A 20-year-old female without immunocompromise was referred to our clinic complaining of cough with hemoptysis. Chest radiology showed multiple small lung nodules at the bilateral sides the upper lung. After received regular anti-tuberculosis therapy and experiential anti-fungal therapy, the lesions in lung get worse. The biopsy was pursued the diagnosis was Mycobacterium avium lung disease. The diagnosis can not make correctly even after the pathological inspection combined with special stain of slides. The diagnosis was figured out through lung tissue-based mycobacterial culture finally. Keywords: Mycobacterium avium; Non-tuberculous mycobacterial lung disease; Herxheimer-like reaction; Non-immunocompromise; Lung biopsy 15 0 Introduction Although the epidemiology of pulmonary tuberculosis (TB) is well described, the prevalence and epidemiology of non-tuberculous mycobacterial (NTM) lung disease is largely unknown. The incidence of NTM is increasing in the non-AIDS population [1-3]. The ATS/IDSA statement on 20 25 30 35 40 NTM [4] described that the minimum evaluation of a patient suspected of NTM lung disease should include the following:(1) chest radiograph or, in the absence of cavitation, chest high-resolution computed tomography (HRCT) scan; (2) three or more sputum specimens for acid-fast bacilli (AFB) analysis; and (3) exclusion of other disorders, such as TB. Confirmed diagnosis should include further specific characters such as clinical, radiologic, and microbiologic criteria. Therefore, it is difficult to make a diagnosis of pulmonary NTM disease in clinic. Here we report a case of pulmonary NTM disease proved by lung biopsy in non-immunocompromised patient. 1 Case report A 20-year-old female student was admitted to hospital f