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[A case of Mycobacterium abscessus pulmonary infection; effectiveness of clarithromycin, amikacin and imipenem/cilastatin].
- Source :
-
Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society [Nihon Kokyuki Gakkai Zasshi] 2006 Nov; Vol. 44 (11), pp. 800-6. - Publication Year :
- 2006
-
Abstract
- A 42-year-old woman presented with persistent cough, bloody sputum and fever. Her chest X-ray film showed an infiltrative shadow with cavitation in the upper lobe of the left lung. Acid-fast-bacilli were shown by sputum smear staining. The anti-tuberculosis drugs isoniazid, refampicin, ethambutol and pyrazinamide were prescribed, but her symptoms and chest X-ray findings did not improve. Findings of MTD and MAC-PCR were negative but Mycobacterium abscessus was confirmed by sputum culture with the DNA hybridization method. Combination therapy with clarithromycin, amikacin and imipenem/cilastatin for one month improved her symptoms and chest X-ray shadow, and clarithromycin monotherapy was carried out for another ten months. Drug susceptibility tests revealed this mycobacterium was sensitive to clarithromycin and amikacin. To determine the environmental factors related to this infection, several samples were examined. Acid-fast-bacilli were present in a smear from the bath room drain. However, to confirm the infectious routes, longer observation is needed. Moreover, serum amyloid protein A and ESR were useful markers to estimate the clinical course.
- Subjects :
- Adult
Amikacin administration & dosage
Cilastatin administration & dosage
Cilastatin, Imipenem Drug Combination
Clarithromycin administration & dosage
Drug Combinations
Drug Therapy, Combination
Female
Humans
Imipenem administration & dosage
Mycobacterium Infections, Nontuberculous diagnostic imaging
Nontuberculous Mycobacteria isolation & purification
Radiography, Thoracic
Tuberculosis, Pulmonary diagnostic imaging
Anti-Bacterial Agents therapeutic use
Mycobacterium Infections, Nontuberculous drug therapy
Tuberculosis, Pulmonary drug therapy
Subjects
Details
- Language :
- Japanese
- ISSN :
- 1343-3490
- Volume :
- 44
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society
- Publication Type :
- Academic Journal
- Accession number :
- 17144576