Mycobacterium gordonaeに よる肺非結核性抗酸菌症の1例

1 482. Mycobacterium gordonae 1 . 1), 2). 1)2) 1) 1) 1). ( 11 1 27 ). ( 11 2 23 ). Key words: Mycobacterium gordonae, nontuberculous mycobacteriosis X , . Mycobacterium gordonae( , . ) (nontuberculous mycobac- : 154cm, 45kg, 133/70. teria, NTM ) , mmHg, 100/ , , , . , , , .. 1) 6). , , . AIDS .. 7). NTM . 8) 10). : , .. 25 27mm .. Table1 ..1995 10 16 X . NTM . ( ). CTscan . , S1+2 ,S6 .. ( ). :57 , . :1995 11 : . complex( MAC ) 33 . :1994 7 . ,NTM ,clarithromycin( . : . CAM) .1996 . :1994 4 Mgo donae , . , . 7 , , , donae .1997 10 ri- , fampicin( RFP) ..1995 9 X , ..10 , .. :( 160-0023) 6- Runyon II . 7-1. NTM , .. NTM . 73 5 . 1 483. Table1 @ Drug sensitivity of M. gordonae *SM: streptomycin , PAS: para-aminosalicylic acid, INH: isoniazid, KM: kanamycin, CS: cycloserine, EB: ethambutol, RFP: rifampicin @ Chest roentgenogram obtained on October @ Chest CT scan obtained on November 9, 1995, 16, 1995, showing infiltrations in the left middle lung showing bronchiectasis in S1+2and small nodular field.

2 Shadows in S6 of the left lung. MAC ,5 15% 9) 11).. AIDS .. 11 5 20 . 484 . 7). , M. 3 , 10 .NTM . gordonae 7 38% , 9) 11) .. 1) 6)..NTM . , .. 12). 1984 , . , . 13) , .. 21 . 1997 (ATS) , . 14) . ( 2 . ).NTM. , 1980 , .. 13 20% 10)15).. MAc 46 80%, 1 40% . , . 9)10)15) 17).. AIDS NTM . , AIDS compromised , host , .. NTM .. 1995 11 1998 1 . 5 4 M. , . gordonae ,1996 3 .. 3+ . 2 .. , ,compro- mised host .. DNA/DNA .. NTM .. ,37 S . isoniazid,RFP, ( ) Runyon II ethambutol 3 , streptomycin .. Tween80 ,EB . (5 g) , . 2) 6)18) 20).. RFP . 20). CAM,RFP .RFP.. , ,RFP , X.. 1995 , NTM . 11 MAC , . ,1 ,contamination .. 1996 1 1998 12 3 , NTM . 80 NTM MAC CAM M.. kansasii RFP . ,MAC22 , , 14).. 73 5 . 1 485. NTM : . 1997; 72: 435-442.. 10) , , , , . , : . 1994; 69: 483- , 490.

3 , , 11) : .. , 1976; 51: 67- 70. , , . 12) : Mycobacterium gordonae .. 1983; 37: 456-461. 13) : . 1) , , , : My- ( ) . 1985;. cobacterium gordonae . 60: 51. 1987; 62: 281-285. 14) American Thoracic Society: Diagnosis and 2) , , : M. gordonae treatment of disease caused by nontuberculous M. kansasii 1 . mycobacteria. Am J Respir Crit Care Med 1997;. 156: S1-S25. 1988; 63: 785-790. 3) , , , : 15) : .. 1 . 1994; 10: 2257-2263. 16) , , , , . 1994; 71: 439-442. 4) , , , , , : . , : Mycobacterium gordonae - . -. 1998; 73: 287-293. 1 . 1987; 6: 17) : . 545-548. 5) , , , , -Mycobacte- , : Mycobacterium gordonae rium knasasii , . 1 . 1991; 15: 91-94. -. 1987;. 6) , , : 62: 319-327. Mycobactlrium gordonae 1 18) Gracia J, Vidal R, Martin N, Bravo C, Gonzalez T, . 1992; 30: 343-346.

4 Riba A: Pulmonary disease caused by Mycobac- 7) Lessnau KD, Milanese S, Talavera W: Mycobacte- terium gordonae. Tubercle 1989; 70: 135-137. rium gordonae: Atreatable disease in HIV- 19) Clague H, Hopkins CA: Pulmonary infection positive patients. Chestl993; 104: 1779-1785. with Mycobacterium gordonae in the presence of 8) : bronchial carcinoma. Tubercle1985; 66: 61-63. - 20) Nathan V, Mehta JB, Dralle W: Rifabutin in the -. 1988; 63: treatment of cavitary lung disease due to Myco- 493-499. bacterium gordonae. South Med J1993; 86: 839- 9) , , : 841. Pulmonary Infection Caused by Mycobacterium Gordonae Naoshi YANAGISAWA1)2), Daisuke MIYAMOTO1), Yuichi ICHINOSE1)& Keisuke TOYAMA1). 1)First Department of Internal Medicine , Tokyo Medical College 2)Department of Internal Medicine , Tachikawa Hospital A57-year-old woman who had been operated on for colon cancer and given chemotherapy, pre- sented in September 1995with worsening cough and abnormalities on her chest X-ray film.

5 Acid-fast bacilli were isolated from the sputum. The organism was classified as by biochemical tests and DNA/DNA hybridization. The patient was treated with rifampicin and clarithromycin. Subsequently, sputum cultures became negative and the chest x-ray film showed a decrease infiltra- tion. The findings in the present case suggest that M. gordonae may cause pulmonary infection and should be considered as an opportunistic pathogen. A. Inf. : 482 485, 1999 . 11 5 20.