Annals of The Japanese Respiratory Society:A case of disseminated nontuberculous mycobacteriosis diagnosed by biopsy from multiple organs

Vol.13 No.4 Table of Contents

Abstract

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Article in Japanese

Case Report

A case of disseminated nontuberculous mycobacteriosis diagnosed by biopsy from multiple organs

Chihoka Nakai^a,* Taro Yoneda^a Kazuyuki Kakeshita^a Keigo Saeki^a Hiroko Morita^b Hayato Koba^c

^aDepartment of Internal Medicine, Komatsu Municipal Hospital
^bDepartment of Internal Medicine, Morita Hospital
^cDepartment of Respiratory Medicine, Kanazawa University Hospital
^*Present address: Department of Respiratory Medicine, Ishikawa Prefectural Central Hospital

ABSTRACT

A 78-year-old man visited our hospital with fever, fatigue, and back pain. The computed tomography (CT) scan revealed infiltrative shadows in the middle lobe of the right lung, multiple bone lesions, and multiple abscess formation. We performed bronchoscopy, bone marrow examination, and CT-guided bone biopsy. As Mycobacterium intracellulare was detected in several specimens, disseminated non-tuberculous mycobacterium tuberculosis (DNTM) was diagnosed. Anti-interferon-γ neutralizing autoantibody was detected from a blood sample. The patient’s symptoms improved with medical treatment for NTM disease, and the C-reactive protein, alkaline phosphatase, and sIL-2R levels also decreased. DNTM is often associated with bone lesions and must be differentiated from lung cancer and malignant lymphoma. Biopsies from multiple sites are recommended for a definitive diagnosis.

KEYWORDS

Disseminated nontuberculous mycobacterial infection Soluble interleukin-2 receptor (sIL-2R) Anti-IFN-γ neutralizing autoantibody

Received 20 Nov 2023 ／ Accepted 27 Mar 2024

AJRS, 13(4): 170-174, 2024

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