2017 Volume 39 Issue 2 Pages 170-175
Background. There are few reports of tracheobronchial lesions due to nontuberculous mycobacterial infections. Case. A follow-up CT scan revealed a nodule with a cavity in a 67-year-old man who had previously undergone surgery for sigmoid colon cancer in his left upper lobe. He was admitted to our hospital in March 201X. Mycobacterium fortuitum (M. fortuitum) was cultured from a sample obtained during bronchoscopy, and the patient was followed without medication. A CT scan in May 201X+1 revealed that the left upper lobe nodule had become larger and showed the appearance of another nodule in the right main bronchus. Mycobacterium avium (M. avium) was cultured from a sputum specimen. Thus, we started antibiotic therapy in September of that year, and the patient's sputum culture became negative. In February 201X+2 M. fortuitum grew in sputum culture, and bronchoscopy was performed. We found a tumefactive lesion at the membranous portion of the right main bronchus, which had been observed on the CT scans, and necrotic material was drained by brushing. We considered the lesion to have been caused by M. fortuitum infection, and added levofloxacin to his antibiotic therapy. Thereafter, the clinical course was good. Conclusion. We reported the case of a patient with a bronchial wall lesion that was suspected to be a M. fortuitum infection.
