Mycobacterium abscessus lung disease in a patient with previous pulmonary tuberculosis.

Patients with pre-existing lung damage, such as due to pulmonary tuberculosis (PTB), are susceptible to nontuberculous mycobacteria (NTM) infections. For patients with previous PTB, it is difficult to differentiate NTM lung disease from PTB, especially in tuberculosis (TB) high-burdened countries. Here, we report a case of Mycobacterium abscessus lung disease with a previous history of PTB. The patient underwent a right upper lobe lobectomy due to disappointing treatment response with anti-tuberculosis therapy. However, the disease worsened after the surgery. Five years later, she was diagnosed with M. abscessus lung disease. Successive computed tomography (CT) scans showed the progressing features of M. abscessus lung disease. This patient had multiple micronodules adjacent to the pleura with a positive culture for NTM. Bilateral bronchiectasis without lobar predominance are valuable features for distinguishing M. abscessus lung disease from other mycobacterial lung disease.

Case finding and diagnosis for active pulmonary tuberculosis with primary treatment:an analysis of 1000 inpatients / 中华全科医师杂志

ObjectiveTo study the modes of case finding and diagnosis for inpatients of active pulmonary tuberculosis with primary treatment.MethodsData of 1000 inpatients with active pulmonary tuberculosis input into a computer were analyzed retrospectively.including clinical symptoms,signs and relevant laboratory examinations.to evaluate their diagnostic value.ResultsAmong 1000 active tuberculosis case8 hospitalized with symptoms and signs,95.9 percent suffered by cough,77.7 percent by expectoration and 50.8 percent (n=508) by fever,and 51.5 percent (n=777) with strong positive purified protein defivative (PPD) skin test,61.5 percent with positive serum anti-tuberculosis antibody,48.8 percent with positive acid-fast staining on sputum smear and 57.9 percent with positive sputum bacteriologle culture.And,49.4 percent of the patients were diagnosed by laboratory positive sputum,and 50.6 percent of those with negative sputum were diagnosed by comprehensively clinical considerations,ineluding 51.6 percent positive PPD skin teat, or positive serum anti-tubereulosis antibody,but 48.4 percent of them were all negative in varied laboratory examinations.ConclusionsHospital visit due to symptom is the main method for tuberculosis finding in our country.All those with Cough for two or more weeks should be screened by routine examinations for excluding tuberculosis.Case finding rate Was low by sputum examinations.so comprehensive diagnosis is still important for those tuberculosis patients with negative sputum.