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폐암 치료 후 발생한 기관지 침범 Mycobacterium intracellulare 감염 1예
조형준 ( Hyeong Jun Cho ),이종민 ( Jongmin Lee ),이진국 ( Chin Kook Rhee ),김승준 ( Seung Joon Kim ),김석찬 ( Seok Chan Kim ),김영균 ( Young Kyoon Kim ),강지영 ( Ji Young Kang ) 대한내과학회 2022 대한내과학회지 Vol.97 No.6
The incidence of nontuberculous mycobacterial pulmonary disease is increasing, and Mycobacterium avium complex (MAC) is the most common causal species. Patients with underlying structural lung disease or an immunosuppressive condition are at increased risk for MAC infections. Endobronchial lesions caused by MAC infection are extremely rare, especially in immunocompetent hosts. Here, we describe a case of a 58-year-old woman with pulmonary infiltration and endobronchial involvement caused by MAC. The patient had shortness of breath and a productive cough. She had undergone surgery and chemoradiotherapy for lung cancer 10 years prior. Radiological findings revealed small centrilobular nodules with consolidation in the right lung and mild stenosis at the right main bronchus. Bronchoscopy revealed yellowish-white caseous necrosis in the right main bronchus. Mycobacterium intracellulare was identified in bronchial washing fluid. She was treated with antimicrobial medications. After 6 months of treatment, bronchial lesions, radiological findings, and symptoms had improved remarkably and she showed culture conversion. (Korean J Med 2022;97:375-380)