Tuberc Respir Dis.  2012 Feb;72(2):173-176.

Nontuberculous Mycobacterial Lung Disease Caused by Mycobacterium terrae in a Patient with Bronchiectasis

• Koh WJ
• Choi GE
• Lee NY
• Shin SJ

Abstract

We report a rare case of lung disease caused by Mycobacterium terrae in a previously healthy woman. A 45-year-old woman was referred to our hospital due to a chronic cough with sputum. A computed tomography scan of the chest revealed bronchiolitis in conjuction with bronchiectasis in both lungs. Nontuberculous mycobacteria were identified and isolated from the bronchoalveolar lavage fluid collected from each lung. All isolates were identified as M. terrae by various molecular methods that characterized the rpoB and hsp65 gene sequences. Antibiotic therapy using clarithromycin, rifampin, and ethambutol improved the patient's condition and successfully resulted in sputum conversion.

Keyword

Bronchiectasis; Mycobacterium Infections, Nontuberculous

MeSH Terms

Bronchiectasis
Bronchiolitis
Bronchoalveolar Lavage Fluid
Clarithromycin
Cough
Ethambutol
Female
Humans
Lung
Lung Diseases
Middle Aged
Mycobacterium
Mycobacterium Infections, Nontuberculous
Nontuberculous Mycobacteria
Rifampin
Sputum
Thorax
Clarithromycin
Ethambutol
Rifampin

Figure

• 

  Figure 1 A 45-year-old woman with bronchiectasis and nontuberculous mycobacterial lung disease caused by Mycobacterium terrae. (A) A transverse CT scan (2.5-mm-section thickness) obtained on level with the right inferior pulmonary vein at the time of presentation, before treatment, reveals bilateral bronchiectasis (arrows) in the right middle lobe and the lingular segment of the left upper lobe, as well as cellular bronchiolitis with tree-in-bud signs (black arrow heads) in both lungs. Lobular consolidation in the right middle lobe (white arrow heads) was also noted. (B) A CT scan of the same patient after 12 months of antibiotic therapy revealed a decrease in the extent of cellular bronchiolitis and lobular consolidation in both lungs. CT: computed tomography.

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  Figure 2 Electrophoresis of the PCR restriction enzyme PRA of the rpoB and hsp65 genes from the clinical isolate of the patient. M, size marker; Lane 1, rpoB gene PCR product after digestion by MspI Lane 2, PCR product of the rpoB gene after digestion by HaeIII Lane 3, PCR product of the hsp65 gene after digestion by HaeIII. PCR: polymerase chain reaction; PRA: polymorphism analysis.

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