Abstract
We report two surgical cases of pulmonary Mycobacterium abscessus (M. abscessus) infection. Case 1, a 45-year-old male with no previous medical history, complained of a cough, persistent fever, dyspnea, and chest pain. Case 2, a 75-year-old male with a previous history of pulmonary tuberculosis and Mycobacterium intracellulare infection, showed symptoms of productive cough and hemoptysis. Both had focal infections in their right upper lobes, and underwent right upper lobectomies. They were also treated with clarithromycin (CAM), amikacin (AMK), and imipenem/cilastatin (IPM/CS) perioperatively. Their clinical symptoms improved, and they are alive with a negative sputum examination for M. abscessus. We investigated the reported thirty-two cases of pulmonary M. abscessus infection in Japan. Nine of them had a medical history of pulmonary tuberculosis, and 7 of them had malignant disease. No distinctive features were detected regarding the gender, age, and infected locations. Medication with CAM, AMK, and IPM/CS was reported to be effective in 8 cases, although various antibiotics were prescribed in 31 cases. Pulmonary resections were performed in 5 cases, and they were all discharged with no sputum excretion of M. abscessus. Pulmonary M. abscessus infection cure has been reported to be difficult, but a combination of surgical procedures and chemotherapies including CAM, AMK, and IPM/CS should be considered for tolerable patients with pulmonary resection.
