Abstract
Background. Hypersensitivity pneumonia-like lung disease by nontuberculous mycobacterium has been described in immunocompetent condition, recently. Case. A 65-year-old woman was pointed diffuse lung opacities by chest roentgenogram. Chest CT showed middle lobe atelectasis, tiny nodules with centrilobular distribution, and lymphadenopathy. Those radiologic findings were clearly improved after admission, but, were re-worsened after temporal stay in home. A lung biopsy was performed. Surgical materials revealed epithelioid cell granulomatous inflammation in the both of lymph nodes and lung, and Mycobacterium avium was detected in the middle lobe, but not in the upper lobe. Her clinical condition was similar to hypersensitivity pneumonia. Pulmonary lesions changed better after antimycobacterial therapy and house-changing was introduced. Conclusion. A hypersensitivity pneumonia-like reaction due to nontuberculous mycobacterium can occur in the circumstances other than hot tub. Pulmonary response to Mycobacterium avium in this patient is complicated for both an infection and hypersensitivity-like disease.
