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Mochizuka Y, Kono M, Hirama R, Oshima Y, Takeda K, Tsutsumi A, Miwa H, Miki Y, Hashimoto D, Kimura T, Sakagami T, Nakamura H. Endobronchial Lesions from Disseminated Mycobacterium avium Infection in a Patient with Anti-interferon-gamma Autoantibodies. Intern Med 2021; 60:3267-3272. [PMID: 33896863 PMCID: PMC8580776 DOI: 10.2169/internalmedicine.6693-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A 78-year-old man was admitted to our hospital with a fever and left chest pain. Computed tomography showed multiple lung nodules, narrowing of the right bronchus intermedius with mediastinal lymphadenopathy, and an osteolytic lesion. Bronchoscopic findings showed rapid progression of multiple polypoid lesions and the bronchial stenosis. A biopsy of the endobronchial lesions revealed non-necrotizing granulomatous inflammation, and a tissue culture identified Mycobacterium avium. An anti-human immunodeficiency virus antibody was negative. Finally, anti-interferon-gamma (IFN-γ) autoantibodies were detected, and the patient was diagnosed with disseminated nontuberculous mycobacterium infection with anti-IFN-γ autoantibodies. Antimycobacterial therapy was effective, and radiographic findings, including the endobronchial lesions, were resolved.
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Affiliation(s)
- Yasutaka Mochizuka
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Masato Kono
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Ryutaro Hirama
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Yuiko Oshima
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Kenichiro Takeda
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Akari Tsutsumi
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Hideki Miwa
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Yoshihiro Miki
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Dai Hashimoto
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Toshiki Kimura
- Department of Respiratory Medicine, Faculty of Life Sciences, Kumamoto University, Japan
| | - Takuro Sakagami
- Department of Respiratory Medicine, Faculty of Life Sciences, Kumamoto University, Japan
| | - Hidenori Nakamura
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
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Keshishyan S, DeLorenzo L, Hammoud K, Avagyan A, Assallum H, Harris K. Infections causing central airway obstruction: role of bronchoscopy in diagnosis and management. J Thorac Dis 2017; 9:1707-1724. [PMID: 28740687 DOI: 10.21037/jtd.2017.06.31] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways. However, bronchoscopy is commonly used to confirm and obtain a specific diagnosis to guide specific therapy. In recent years, interventional pulmonology (IP) is becoming widely available and offer a minimally invasive approach for the management of central airway diseases such as cancers, benign strictures, and other conditions. Various bronchoscopic modalities are used to treat central airway obstruction (CAO), such as mechanical debulking, endobronchial laser therapy, electrocautery, argon plasma coagulation, cryotherapy, and airway stenting. In patients with CAOI, the role of therapeutic bronchoscopy is not clearly defined, but many isolated reports in the literature described bronchoscopic intervention in combination with medical therapy as the initial management approach. In this paper, we present cases of CAOI that underwent bronchoscopic intervention as part of their management. We described the infectious etiology, locations, bronchoscopic findings and bronchoscopic modalities for airway management.
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Affiliation(s)
- Sevak Keshishyan
- Division of Pulmonary and Critical Care, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
| | - Lawrence DeLorenzo
- Division of Pulmonary and Critical Care, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
| | - Kassem Hammoud
- Department of Infectious Diseases, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Arpine Avagyan
- Division of Internal Medicine, Department of Medicine, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Hussein Assallum
- Division of Pulmonary and Critical Care, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
| | - Kassem Harris
- Section of Interventional Pulmonology, Division of Pulmonary Critical Care and Sleep, Department of Medicine, Westchester Medical Center, Valhalla, New York, USA
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Kim HI, Kim JW, Kim JY, Kim YN, Kim JH, Jeong BH, Chung MJ, Koh WJ. Isolated Endobronchial Mycobacterium avium Disease Associated with Lobar Atelectasis in an Immunocompetent Young Adult: A Case Report and Literature Review. Tuberc Respir Dis (Seoul) 2015; 78:412-5. [PMID: 26508935 PMCID: PMC4620341 DOI: 10.4046/trd.2015.78.4.412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/06/2015] [Accepted: 07/08/2015] [Indexed: 11/24/2022] Open
Abstract
The prevalence of lung diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. Unlike pulmonary tuberculosis, endobronchial NTM diseases are very rare with the majority of cases reported in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome. We reported a rare case of endobronchial Mycobacterium avium disease associated with lobar atelectasis in a young immunocompetent patient and reviewed the relevant iterature.
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Affiliation(s)
- Hye In Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Young Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Nam Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hae Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung Jin Chung
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won-Jung Koh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lyons J, Vandenberghe E, Fahy R, McDonnell C, Keane J, McLaughlin AM. An unusual lung mass post stem cell transplantation. Transpl Infect Dis 2014; 16:672-5. [PMID: 24995624 DOI: 10.1111/tid.12257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 01/17/2014] [Accepted: 03/30/2014] [Indexed: 11/28/2022]
Abstract
We report a case of Mycobacterium kansasii presenting as an obstructing endobronchial mass in a patient post stem cell transplant. The patient had a complete clinical, microbiological, and radiological response to anti-tuberculous treatment. To our knowledge, this is the first case of M. kansasii presenting post transplant with an obstructing lung mass simulating relapse or post-transplant lymphoma.
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Affiliation(s)
- J Lyons
- Department of Respiratory Medicine, St James's Hospital, Dublin, Ireland
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Kim MS, Han JW, Jin SS, Lee JM, Hah JH, Kim YJ, Kim SJ, Kang MW, Kang JY. A Case of Mycobacterium kansasii Pulmonary Disease Presenting as Endobronchial Lesions in HIV-Infected Patient. Tuberc Respir Dis (Seoul) 2013; 75:157-60. [PMID: 24265644 PMCID: PMC3833936 DOI: 10.4046/trd.2013.75.4.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/14/2013] [Accepted: 07/17/2013] [Indexed: 11/30/2022] Open
Abstract
Incidence of nontuberculous mycobacterium (NTM) pulmonary disease is increasing with the wider recognition and development of diagnostic technology. Mycobacterium kansasii is the second most common pathogen of NTM pulmonary disease in human immunodeficiency virus (HIV)-infected patients. However in Korea, the incidence of M. kansasii pulmonary disease is relatively low, and there has been no report of M. kansasii pulmonary disease with bronchial involvement in HIV patients, to the best of our knowledge. We report a case of M. kansasii pulmonary disease presenting with endobronchial lesions in an HIV-infected patient complaining of chronic cough with bilateral enlargements of hilar lymph nodes on chest X-ray.
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Affiliation(s)
- Moon Sung Kim
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Kang SH, Mun SK, Lee MJ, Kim SY, Choi HG, Byun J, Kim CH, Kim HR, Cho SY. Endobronchial Mycobacterium avium Infection in an Immunocompetent Patient. Infect Chemother 2013; 45:99-104. [PMID: 24265956 PMCID: PMC3780944 DOI: 10.3947/ic.2013.45.1.99] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 09/13/2012] [Accepted: 09/26/2012] [Indexed: 12/03/2022] Open
Abstract
Although Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial (NTM) pulmonary diseases, endobronchial lesions caused by MAC infections are very rare even in an immunocompromised host. Herein, we describe the case of a 59-year-old, HIV-negative and non-immunocompromised woman who developed multifocal pulmonary infiltrations with endobronchial lesion caused by M. avium. Bronchoscopic examination revealed white- and yellow-colored irregular mucosal lesions in the bronchus of the left lingular division. M. avium was identified using sputum culture and bronchial washing fluid culture. Following the recommendations of the American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA), the patient was begun on treatment with antimycobacterial drugs. After treatment, pneumonic infiltration decreased.
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Affiliation(s)
- Seung-Hwa Kang
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Se-Kwon Mun
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Min-Jae Lee
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - So-Yeon Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Hyung-Gyu Choi
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Junsu Byun
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Cheol Hyeon Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Hye-Ryoun Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Soo Yeon Cho
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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Lee JH, Son KS, Park JH, Kim JC, Lee HW, Kim CH. Mycobacterium avium Infection Presenting as Endobronchial Lesions in an Immunocompetent Patient. Tuberc Respir Dis (Seoul) 2006. [DOI: 10.4046/trd.2006.60.5.571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jae Hee Lee
- Department of Internal Medicine, Gumi CHA Hospital, College of Medicine, Pochon CHA University, Korea
| | - Kyung Sik Son
- Department of Radiology, Gumi CHA Hospital, College of Medicine, Pochon CHA University, Korea
| | - Ji Hyun Park
- Department of Internal Medicine, Gumi CHA Hospital, College of Medicine, Pochon CHA University, Korea
| | - Jun Chol Kim
- Department of Internal Medicine, Gumi CHA Hospital, College of Medicine, Pochon CHA University, Korea
| | - Hyun Woo Lee
- Department of Internal Medicine, Gumi CHA Hospital, College of Medicine, Pochon CHA University, Korea
| | - Chang Ho Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Korea
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Ra SW, Lee KH, Jung JY, Kang HS, Park IN, Choi HS, Jung H, Chon GR, Shim TS. Mycobacterium Kansasii Disease Presenting As a Lung Mass and Bronchial Anthracofibrosis. Tuberc Respir Dis (Seoul) 2006. [DOI: 10.4046/trd.2006.60.4.464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Seung Won Ra
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kwang Ha Lee
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ju Young Jung
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho Suk Kang
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - I Nae Park
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hye Sook Choi
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hoon Jung
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Gyu Rak Chon
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tae Sun Shim
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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