 |
The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
A case of Mycobacterium shinjukuense pulmonary infection with slow radiographic progression |
| Language |
J |
| AuthorList |
Michie Miura1), Yasue Hayakawa1), Masaaki Kusunose2) |
| Affiliation |
1) Department of Clinical Laboratory, National Center for Geriatrics and Gerontology
2) Department of Respiratory Medicine, National Center for Geriatrics and Gerontology |
| Publication |
J.J.C.M.: 34 (1), 35-41, 2023 |
| Received |
March 16, 2023 |
| Accepted |
September 25, 2023 |
| Abstract |
Thirteen years ago, a 55-years-old woman was referred to our hospital with an abnormal shadow on chest X-ray. Based on the diagnosis of Mycobacterium avium pulmonary disease from the bronchoscopic examination and surgery resection, she took medication treatment for six months subsequently. Lung lesions were disappeared on chest CT. Five years later, she developed rheumatoid arthritis (RA) and the administration of antirheumatic drugs or biologics were sequentially started. Four years after the diagnosis with RA, granular shadows were newly recognized in the right lower lobe. But no specific diagnosis was made from bronchoscopic examination. Lung abnormalities showed slow progression and another four years have passed when a pulmonary cavity was finally detected in the same lobe. The bronchial lavage fluid was collected once again. The samples were positive for acid fast bacilli smear and culture tests, and then identified as Mycobacterium shinjukuense by matrix-assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS). Its virulence and therapeutic approach have not been established. But considering the lung tissue damage, she was treated with clarithromycin, rifampicin and ethambutol. Chest CT after one-year therapy showed a shrinkage of the pulmonary cavity. MALDI-TOF MS is now an implemented technique covered by health insurance. In this case, this technique was very useful for rapid microbial identification and for the appropriate treatment decision making. |
| Keywords |
Mycobacterium shinjukuense, MALDI-TOF MS |
|
