Two Cases of Atypical Mycobacterial Infection in Side of the Cavity Lesions which were Directly Observed by Fiberoptic Bronchoscopy

Abstract

We report two cases of atypical mycobacterial infection inside cavitated lesions which were directly observed by fiberoptic bronchoscopy. The first case was a 66-year-old man who was admitted with low grade fever and increase of abnormal shadow on the chest X-ray film. Mycobacterium fortuitum infection was diagnosed. A cavity was revealed in the left upper lung field on the chest X-ray film. The cavity was visualized from the peripheral site of B^<1+2> by fiberoptic bronchoscope. The inner surface of the cavity was edematous and dark red. The second case was a 60-year-old woman. She was admitted to this hospital because of hemoptysis. The chest X-ray film showed an irregular inner wall of the left cavity which communicated with the upper division of the left bronchus. The cavity was visualized from the peripheral site of upper division bronchus by fiberoptic bronchoscope. The inner surface of the cavity was edematous and partly dark red and partly pale. Mycobacterium avium complex was cultured from the washing fluid of the inner side of the cavity. The bronchoscopic findings of the inner surface of cavities in these cases resembled that of aspergillosis. One marked difference however, was the quantity of white coating material. In the case of aspergillosis, large amounts of white coating material were found on the surface of cavity. But only a small amount of white coating material was seen on the surface of the cavity in the case of atypical mycobacterial infection. This may be one of the characteristics of atypical mycobacterial infection.