Cases reported "Lung Diseases"

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1/40. Successful treatment of rhodococcus equi pulmonary infection in a renal transplant recipient.

    The rhodococcus is a mycobacterium-like organism which is normally a pathogen in foals. It usually spreads by direct contact or by aerosol from horse faeces and causes pyogranulomatous pulmonary infections. Occasionally, it acts opportunistically to infect immuno-compromised human hosts, most commonly those with the acquired immune deficiency syndrome (AIDS). Here we report a pulmonary infection by rhodococcus equi in a renal transplant recipient who was successfully treated. The literature on this infection in transplant recipients is also reviewed with respect to manifestations and treatment.
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keywords = mycobacterium
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2/40. Pulmonary mycobacteriosis caused by rifampicin-resistant Mycobacterium szulgai.

    We describe a rare case of pulmonary mycobacteriosis infected with rifampicin (RFP)-resistant Mycobacterium szulgai that was successfully eradicated with clarithromycin (CAM) treatment. An 80-year-old man was admitted to our hospital with a 4-week history of high fever, productive cough and malaise. Chest roentgenogram showed an infiltrative shadow in the left lower lung field. Isolated bacteria from sputum were acid-fast bacilli and identified as M. szulgai by the dna-dna hybridization method. Drug susceptibility tests showed resistance to RFP (MIC>100 microg/ml). Combined treatment with ethionamide, streptomycin and isoniazid based on the results of drug susceptibility tests resulted in clinical and radiologic improvement within two years. Additional treatment with CAM for another year resulted in complete eradication of the mycobacterium.
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keywords = mycobacterium
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3/40. Pulmonary infection caused by an unusual, slowly growing nontuberculous Mycobacterium.

    Mycobacterium triplex, a recently described slowly growing nontuberculous mycobacterium, was isolated from a Finnish patient with pulmonary mycobacteriosis. The disease was successfully treated with antimycobacterial drugs. The strain isolated, which was similar to the type strain but differed slightly from the species description, was regarded as a variant of M. triplex sensu stricto. According to present knowledge this variant of the species has never been isolated before.
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keywords = mycobacterium
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4/40. Mycobacterium simiae Infection in an Immunocompromised Patient without acquired immunodeficiency syndrome.

    We report a case of lung infection due to Mycobacterium simiae in an immunocompromised patient without acquired immunodeficiency syndrome. The patient had multiple pulmonary nodules similar to those seen in cases of lung disease caused by Mycobacterium avium in elderly women. Appropriate therapy for M. simiae disease should be determined because, in some cases, the risk of adverse effects can outweigh the potential benefits of treatment.
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ranking = 0.23281691695666
keywords = avium
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5/40. Human infections due to Mycobacterium lentiflavum.

    Three cases of human disease due to Mycobacterium lentiflavum are reported. In the first, the mycobacterium was responsible for chronic pulmonary disease in an elderly woman; in the second, it gave rise to cervical lymphadenitis in a child; and in the third, it caused a liver abscess in a young AIDS patient.
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keywords = mycobacterium
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6/40. Angiocentric immunoproliferative lesions of the lung associated with diffuse renal involvement.

    A 62-year-old Japanese man presented with high fever, cough, and sputa. Computed tomography (CT) scan of the chest revealed lung infiltrates with air bronchogram of the right middle lobe and mediastinal lymphadenopathy. Bronchoscopic examination was performed, and mycobacterium avium complex was detected from bronchoalveolar lavage fluid. Although the administration of clarithromycin and levofloxacin improved the patient's symptoms, the lung infiltrates on chest CT scan gradually worsened. lung biopsy of segments 4 and 8 by video-assisted thorachoscopy revealed angiocentric and angiodestructive massive lymphoplasmocytic infiltrations with multinucleated giant cells, which were compatible with grade II angiocentric immunoproliferative lesions. The patient was found to have deterioration of renal function, and glomerular filtration rate was 32.6 mL/min. His kidneys were enlarged and showed prominent and diffuse uptake of gallium-67 citrate. Percutaneous renal biopsy revealed massive infiltration of CD4 mononuclear cells, plasma cells, and eosinophils in the interstitium and destruction of normal structure of tubules. blood vessels were destroyed and replaced by inflammatory cells. The combination chemotherapy achieved a remission, and the patient has remained free of disease at 2 years after onset of the illness. We recommend the imaging of kidneys for diagnosis and following renal biopsy to evaluate the renal involvement of angiocentric immunoproliferative lesions.
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ranking = 0.23281691695666
keywords = avium
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7/40. A case of mycobacterium avium complex infection showing solitary pulmonary mass.

    We report a case of mycobacterium avium complex (MAC) infection showing a solitary pulmonary mass. High-resolution computed tomography (CT) revealed a well-defined, lobulated mass (32x25 mm) without calcification, cavitation, or bronchiectasis on the right upper lobe. There were no abnormalities in other sites of the lung even on high-resolution CT. The diagnosis was established by open lung needle biopsy. The patient exhibited a large solitary pulmonary mass caused by MAC infection, suggesting that, although the incidence is rare, MAC infection can show a solitary mass that is radiographically indistinguishable from lung cancer.
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ranking = 1.1640845847833
keywords = avium
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8/40. IS1311 and IS1245 restriction fragment length polymorphism analyses, serotypes, and drug susceptibilities of mycobacterium avium complex isolates obtained from a human immunodeficiency virus-negative patient.

    Six isolates of Mycobacterium avium of genotype dnaJ( ) IS901(-) IS1311( ) IS1245( ) and serotypes 6 (n = 1), 6/9, (n = 2), and 9 (n = 3) were obtained within a 5-month period from a human immunodeficiency virus-negative patient treated for tuberculosis. The isolates were identified with PvuII restriction fragment length polymorphism (RFLP) analysis as a single IS1311 RFLP type and six different IS1245 RFLP types. Six separate colonies/clones obtained by subculture from each of the six isolates were tested for MICs of a set of 10 drugs. This report documents the appearance of isolates that are resistant to antimycobacterial drugs as the duration of therapy increases. Because isolates recovered from the patient following longer duration of treatment were more likely to be resistant to more antimycobacterial drugs, we would conclude that there was selection for antimycobacterial drug-resistant isolates. Analyses of all 36 clones identified three IS1311 and 22 IS1245 types forming three clusters. Tests of 105 environmental samples collected in the home and the work place of the patient yielded 16 mycobacterial isolates, of which one M. avium from soil was of genotype dnaJ( ) IS901( ) IS1311( ) IS1245( ) and serotype 2, and the second M. avium from a vacuum cleaner was of genotype dnaJ( ) IS901(-) IS1311( ) IS1245( ) and serotype 9. overall analyses of the results did not reveal any relation between serotype, RFLP type, and drug susceptibility. Based on the course of the disease in the patient and different serotypes, IS1311 and IS1245 RFLP types of isolates of M. avium we suppose represent polyclonal infection.
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ranking = 1.8625353356533
keywords = avium
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9/40. Systemic nocardiosis following allogeneic bone marrow transplantation.

    Five cases of systemic nocardia infection were diagnosed among 301 allogeneic bone marrow transplant recipients. A sixth case included in this report received her transplant at another institution. The cumulative annual incidence rate of this infection was 1.75%. All patients had been treated previously for acute graft-versus-host disease (GVHD). At the time of diagnosis of systemic nocardia infection, a median of 198 (range 148-1121) days after transplantation, all patients had extensive chronic GVHD and were taking 2 to 3 immunosuppressive medications. Prior to diagnosis of nocardia infection patients had experienced multiple opportunistic infections, including infections with Mycobacterium avium-intracellulare, pneumocystis carinii, and cytomegalovirus antigenemia. Treatment with trimethoprim-sulfamethoxazole (TMP-SMX), ceftriaxone, or carbapenem antibiotics resulted in a median survival of 219 days from the time of diagnosis and an actuarial 1-year survival of 40%. All patients who received more than 2 weeks of therapy were cured of their infections. Notably, 5/6 patients in this cohort were unable to take TMP-SMX because of myelosuppression. In comparison with randomly selected control patients, the use of pentamidine for prevention of P. carinii infection was associated with a marginal increase in the risk of nocardia infection. We postulate that the use of TMP-SMX may be of benefit in the prophylaxis of infections other than P. carinii in patients with chronic GVHD.
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ranking = 0.23281691695666
keywords = avium
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10/40. Uptake of fluorine-18-fluorodeoxyglucose in pulmonary mycobacterium avium complex infection.

    Two patients showing abnormal fluorine-18-fluorodeoxyglucose (FDG) uptake due to mycobacterium avium complex (MAC) infection are presented. Intense focal FDG uptake in the lung field could have been caused by an infectious disease such as MAC. This should be considered as a possibility when FDG whole-body scans of patients with pulmonary nodules are interpreted. To our knowledge, this is the first description of an FDG-positron emission tomography (FDG-PET) image of MAC infection of the lung.
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ranking = 1.1640845847833
keywords = avium
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